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Journal of Ultrasound in Medicine, Vol 10, Issue 10 563-568, Copyright © 1991 by American Institute of Ultrasound in Medicine
Assessment of ovarian tumor vascularity with transvaginal color Doppler sonography
A. C. Fleischer, W. H. Rodgers, B. K. Rao, D. M. Kepple, J. A. Worrell, L. Williams and H. W. Jones 3rd
Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232-2675.
This report describes the results of transvaginal color Doppler sonography
(TV-CDS) of 43 surgically proved ovarian masses. Waveform analyses of the
signals arising from specific vessels (i.e., peripheral, central, septal)
adjacent to and within these masses were correlated to those seen on
macroscopic pathologic evaluation. The mean and standard deviation of the
pulsatility indices (PI) of 32 benign lesions (1.8 +/- 0.8) were higher
than 11 malignant ones (0.8 +/- 0.6) (P = 0.03). However, the range of
benign (4.0 to 0.7) and malignant (1.5 to 0.4) lesions did overlap. Low PIs
(less than 1.0) were found in five relatively benign lesions (one case each
of dermoid cyst, cystadenoma containing a dermoid cyst, endometrioma,
benign sclerosing stromal tumor, and thecoma), but also in all 11 malignant
or borderline malignant lesions (nine cystadenocarcinomas, two germ cell
tumors), causing an overlap between the PIs of some benign and malignant
masses. With a 100% negative predictive value, our preliminary data suggest
that TV-CDS can effectively exclude malignancy. However, with a positive
predictive value of 73%, one in four malignant lesions diagnosed by TV-CDS
will be benign.
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