Journal of Ultrasound in Medicine, Vol 19, Issue 11 783-788, Copyright © 2000 by American Institute of Ultrasound in Medicine
Contrast-enhanced sonography in the examination of benign and malignant adnexal masses
M. R. Orden, S. Gudmundsson and P. Kirkinen
Department of Obstetrics and Gynecology, University of Kuopio, Kuopio University Hospital, Finland.
Our objective was to characterize the properties of an intravascular
ultrasonographic contrast agent in examination of adnexal masses and to
compare contrast agent properties between benign and malignant adnexal
tumors. Fifty-eight consecutively examined women with suspected ovarian
tumors were examined preoperatively by power Doppler ultrasonography, first
without and then with contrast agent enhancement (Levovist). Fourteen women
had ovarian cancer, 3 had borderline ovarian tumors, 18 had benign ovarian
neoplasms, and 23 had functional adnexal cystic masses or endometriomas.
The effect of the contrast agent was evaluated visually and by using
computerized power Doppler signal intensity measurements. In visual
evaluation, the brightness of the power Doppler signal and the amount of
recognizable vascular areas increased in each tumor after contrast agent
administration. The number of vessels in power Doppler ultrasonograms, both
before and after contrast agent enhancement, was significantly higher in
malignant than in benign adnexal masses, as also was the increase in the
number of recognizable vessels after contrast agent administration.
Contrast agent uptake time was significantly shorter in malignant than in
benign tumors. No significant differences were found in the power Doppler
signal intensities or their changes between benign and malignant tumors. In
conclusion, use of sonographic contrast agent facilitates imaging of tumor
vessels. For differentiation of benign and malignant tumors, the kinetic
properties of the contrast agent, such as uptake and washout times, may
have more potential than the use of the contrast agent in anatomic imaging
of the tumor vessels.
