Color Doppler sonography with contrast in the differentiation of ovarian tumors

Authors

  • Eduardo Cardoso Blanco University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Department of Radiology
  • Ayrton Roberto Pastore University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Department of Radiology
  • Angela Maggio da Fonseca University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Department of Radiology
  • Filomena Marino Carvalho University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Department of Radiology
  • Jesus Paula Carvalho University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Department of Radiology
  • José Aristodemo Pinotti University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Department of Radiology

DOI:

https://doi.org/10.1590/S0041-87812003000400001

Keywords:

Transvaginal ultrasound, Color Doppler sonography, Adnexal mass, Ovarian neoplasms, Contrast medium

Abstract

The objective of this study was to differentiate benign ovarian tumors from malignant ones before surgery using color and pulsed Doppler sonography, and to compare results obtained before and after use of contrast medium, thereby verifying whether contrast results in an improvement in the diagnostic sensitivity. METHODS: Sixty two women (mean age 49.9 years) with ovarian tumors were studied, 45 with benign and 17 with malignant tumors. All women underwent a transvaginal color Doppler ultrasonographic exam. A study of the arterial vascular flow was made in all tumor areas, as well as an impedance evaluation of arterial vascular flow using the resistance index. RESULT: Localization of the vessels in the tumor revealed a greater proportion of malignant tumors with detectable internal vascular flows (64%) than benign tumors with such flows (22%). There was a considerable overlap of these findings. The use of contrast identified a greater number of vessels with confirmation in the totality of tumors, but did not improve the Doppler capacity in tumoral differentiation. Malignant tumors presented lower values of resistance index than the benign ones, whether or not contrast was used. The cutoff value for resistance index that better maximized the Doppler sensitivity and specificity was 0.55. Through this value, an increase of the sensitivity after contrast use was obtained, varying from 47% to 82%, while specificity remained statistically unchanged. CONCLUSION: Although the injection of a microbubble agent improved the sensitivity of the method detecting vascularization of tumors, a positive finding for vascularization by this method was not clinically useful in the differentiation of benign and malignant ovarian tumors.

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Published

2003-01-01

Issue

Section

Original Articles

How to Cite

Color Doppler sonography with contrast in the differentiation of ovarian tumors . (2003). Revista Do Hospital Das Clínicas, 58(4), 185-192. https://doi.org/10.1590/S0041-87812003000400001