Journal of Ultrasound in Medicine, Vol 16, Issue 12 819-824, Copyright © 1997 by American Institute of Ultrasound in Medicine
Blood flow in functional cysts and benign ovarian neoplasms in premenopausal women
J. L. Alcazar, T. Errasti and M. Jurado
Department of Obstetrics and Gynecology, Clinica Universitaria de Navarra, University of Navarre, School of Medicine, Pamplona, Spain.
To assess the value of transvaginal color Doppler sonography in the
differentiation of functional cysts from benign ovarian neoplasms in
premenopausal women, 100 premenopausal women with the diagnosis of adnexal
mass were enrolled in a prospective study. All patients underwent
transvaginal color Doppler sonography during the follicular phase. We
evaluated 107 masses. Tumor volume and morphology were assessed, as were
tumor blood flow location, the number of vessels, the resistive and
pulsatility indices, and the peak systolic velocity. Patients were followed
up after 8 to 10 weeks by transvaginal sonography. Functional cysts were
considered when spontaneous resolution occurred. Surgery was performed if a
tumor enlarged or persisted after two scans. Thirty-nine (36.5%) cysts
regressed spontaneously and 68 (63.5%) were removed surgically. Seven of
the latter were follicular or luteal cysts and were considered to be
functional cysts. No carcinoma was found. Arterial blood flow was detected
in 28 (60.8%) functional cysts and in 42 (68.8%) benign neoplasms (P =
0.3446). The vessels were located peripherally in 27 (94.6%) functional
cysts and in 37 (88.1%) benign neoplasms (P = 0.2226). No differences were
found between functional cysts and benign neoplasms in mean resistive index
(0.65, 95% confidence interval: 0.59 to 0.71 versus 0.64, 95% confidence
interval: 0.60 to 0.69), mean pulsatility index (1.47, 95% confidence
interval: 1.17 to 1.84 versus 1.57, 95% confidence interval: 1.26 to 1.86),
number of vessels (1.1, 95% confidence interval: 0.7 to 1.3 versus 1.4, 95%
confidence interval: 1.1 to 1.8), and peak systolic velocity (28.6 cm/s,
95% confidence interval: 24.7 to 34.2 versus 24.9 cm/s, 95% confidence
interval: 21.6 to 28.3). We concluded that transvaginal color Doppler
sonography is not useful to discriminate between functional ovarian cysts
and benign ovarian neoplasms in premenopausal women.
