TRANSVAGINAL COLOR DOPPLER SONOGRAPHY IN OVARIAN-TUMORS

In 129 patients with ovarian tumours, a preoperative examination by transvaginal colour Doppler sonography (ATL UM9 HDI) was performed. 45 were malignant and 84 benign. 46 patients were premenopausal and 83 postmenopausal. All tumour vessels were anlaysed by spectrum analysis. The number of tumour vessels and the lowest resistance index (RImin) and pulsatility index (PImin) of all vessels were evaluated as diagnostic criteria of the neovascularisation. Up to 19 vessels were found in 115 (89%) tumours. In benign lesions, the number of vessels was significantly lower than in malignancies (median 3 versus 9, p < 0,0001). The RImin and PImin values between benign and malignant tumours were also significantly different, independent of the menopausal status. In postmenopausal patients, the median RImin in 42 benign tumours was 0.62 (0.26-1.0) and in 41 malignancies 0.40 (0.22-0.66). The median PImin was 0.98 (0.31-5.84) in benign tumours and 0.53 (0.25-1.22) in malignant tumours. However, due to the overlapping range between benign and malignant tumours, these parameters do not allow an accurate differentiation. With a cut off value for RImin = 0.5 and PImin = 0.7, the sensitivity is 85% or 82.5% respectively. The specificity for RImin and PImin is 77%, and the diagnostic accuracy is 84% and 80% respectively. The correlation coefficient between RImin and PImin is 0.99 in benign and malignant tumours and both indices are adequate. The calculation of the RI is more easily available and should be preferred as a diagnostic parameter.