EVALUATION OF ADNEXAL MASSES USING 3-DIMENSIONAL ULTRASONOGRAPHIC TECHNOLOGY - PRELIMINARY-REPORT

The purpose of the current study was to demonstrate the ability of thr ee-dimensional ultrasonographic technology to enhance the morphologic scoring system and further improve the ability to differentiate benign from malignant ovarian masses. We performed conventional two-dimensio nal and three-dimensional transabdominal and transvaginal ultrasonogra phy on eight women with adnexal masses. All patients underwent explora tory laparotomy or diagnostic laparoscopy. The three-dimensional ultra sonographic findings were compared with the two-dimensional ultrasonog rams, the intraoperative observations, and gross and histopathologic f indings. The morphologic scoring system as described by Sassone and co workers was adopted, with scores of less than 9 suggestive of benign l esions, and this system was applied in both the two-dimensional and th ree-dimensional ultrasonographic examinations. The morphologic scores were subsequently compared. The images were dissected in the XYZ plane s, and the areas suggestive of malignancy, as suggested by two-dimensi onal ultrasonography, were determined to be either negative or positiv e and confirmatory. In each of the eight adnexal masses, three-dimensi onal ultrasonography confirmed the preoperative diagnoses. The morphol ogic scores did not differ between two-dimensional and three-dimension al ultrasonograms for the benign cysts. In one case of benign solid fi broma, both the two-dimensional and three-dimensional gray scale morph ologic scores were falsely positive at greater than 9. In one case of malignant serous papillary cystadenocarcinoma the two-dimensional morp hologic score was a 9, whereas the three-dimensional score was 13. Thi s difference in scores can be attributed to the additional views avail able with three-dimensional volume scanning, which allowed better char acterization of the pathologic conditions. In addition, three-dimensio nal sonographic technology had the added advantage of high-speed image acquisition and recording to decrease the time of scaling to improve patient comfort. Furthermore, three-dimensional ultrasonography allowe d the real-time analysis of the acquired image data to be conducted at a later time when the patient is off the examination table. Our preli minary results suggest that three-dimensional transvaginal ultrasonogr aphic technology can enhance and facilitate the morphologic evaluation of both benign and malignant adnexal masses.