COMPLEX ADNEXAL MASS IN PREGNANCY - PREDICTIVE VALUE OF COLOR DOPPLERSONOGRAPHY

We sought to establish color Doppler sonographic criteria specific to benign and malignant neoplasms in pregnant patients for parameters alr eady reported for complex adnexal masses in nongravid patients. Thirty -four patients with complex adnexal masses were evaluated during the s econd trimester with transabdominal sonography and transvaginal color Doppler sonography. The lowest pulsatility index obtained was chosen t o be indicative of histologic type. A pulsatility index of less than 1 .0 in a morphologically suspect area was taken to be suggestive of mal ignancy Prospective diagnoses made by color Doppler sonography were co mpared with actual histologic diagnosis. Three malignant ovarian lesio ns and five tumors of low malignant potential were identified correctl y, with a sensitivity of 0.89 and a mean pulsatility index of 0.71 (ra nge, 0.44 to 1.3). The mean pulsatility index for benign masses was 1. 21 (range, 0.4 to 2.8) (P = 0.03). The negative predictive value of a pulsatility index greater than 1.0 was 0.93. The positive predictive v alue and false-positive rate for a pulsatility index less than 1.0, ho wever, were 0.42 and 0.48, respectively. Low impedance was associated with malignant ovarian masses detected during pregnancy. A considerabl e overlap in blood flow patterns, however, may cause incorrect assignm ent of malignant potential to some benign lesions.