WS09‐06What does contrast media add to three dimensional power Doppler evaluation of adnexal masses?

Abstract

AimTo investigate the potential usefulness of contrast enhanced three‐dimensional (3D) power Doppler sonography in the differentiation of benign and malignant adnexal lesions.MethodsA total of 31 patients with complex adnexal lesions of uncertain malignancy at transvaginal B mode and/or color Doppler sonography were prospectively evaluated with three‐dimensional power Doppler sonography before and after injection of the contrast agent. Presence of a penetrating pattern and a mixed penetrating and peripheral pattern suggested adnexal malignancy.The results were compared with histopathology.ResultsThere were 10 cases of ovarian malignancy and 21 benign adnexal lesions. Of the 10 ovarian cancers, 6 (60%) showed vascular distribution suggestive of malignancy at nonenhanced 3D power Doppler sonography. After injection of contrast agent, a penetrating vascular pattern and/or a mixed penetrating and peripheral pattern were detected in all cases of ovarian malignancy with two benign lesions (fibroma and cystadenofibroma) which were misdiagnosed as malignant. The use of a contrast agent with three‐dimensional power Doppler sonography showed diagnostic efficiency (96.7%) that was superior to nonenhanced 3D power Doppler sonography (93.5%).ConclusionContrast enhanced 3D power Doppler sonography provides better visualizatoin of tumor vascularity in complex adnexal masses. If used together with 3D morphological ultrasound assessment, enhanced 3D power Doppler imaging might precisely discriminate benign from malignant adnexal lesions.