Journal of Ultrasound in Medicine, Vol 20, Issue 8 829-840, Copyright © 2001 by American Institute of Ultrasound in Medicine
Preoperative evaluation of pelvic tumors by Doppler and three-dimensional sonography
A. Kurjak, S. Kupesic, V. Sparac and I. Bekavac
Department of Obstetrics and Gynecology, Medical School, University of Zagreb, Sveti Duh Hospital, Croatia.
OBJECTIVE: To study a spectrum of systems (two-dimensional transvaginal,
transvaginal color Doppler, three-dimensional, three-dimensional power
Doppler, and contrast-enhanced three-dimensional power Doppler sonography)
for preoperative evaluation of pelvic tumors. METHODS: Two hundred
ninety-two patients were evaluated by the 5 complementary methods in
preoperative sonographic assessments. We examined adnexal and endometrial
morphology, thickness, and volume by two- and three-dimensional sonography
and analyzed blood flow by transvaginal color, pulsed Doppler, and
three-dimensional power Doppler sonography in all examined patients. In 89
patients with complex adnexal lesions of uncertain malignancy,
contrast-enhanced three-dimensional power Doppler sonography was performed.
RESULTS: Morphologic assessment by three-dimensional sonography yielded
additional information in 58% of cases compared with two-dimensional
sonography. Furthermore, this modality was superior to two-dimensional
sonography in accurate depiction and diagnosis of 2 cases of fallopian tube
carcinoma. Combined morphology and vascular indexing reached sensitivity of
97% and specificity of 99%. Endometrial volume in patients with malignant
disease was significantly different (28.2 +/- 0.02 cm3) from that in those
who had hyperplasia (7.81 +/- 0.03 cm3), polyps (3.5 +/- 0.02 cm3), or
normal endometria (0.8 +/- 0.02 cm3). With combined morphologic and
three-dimensional power Doppler examination of endometrial lesions,
sensitivity and specificity reached 89% and 97%, respectively. CONCLUSIONS:
Combined morphologic and vascular imaging improves preoperative assessment
of gynecologic tumors.
