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Sonographic Depiction of Intratumoral Vascularity With 2- and 3-Dimensional Color Doppler Techniques

Departments of Radiology (A.C.F.), Obstetrics and Gynecology (A.C.F., M.R.M., M.A.C.), and Pathology (A.W.S.), Vanderbilt University Medical Center, Nashville, Tennessee USA.

Address correspondence and reprint requests to Arthur C. Fleischer, MD, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1161 21st Ave S, Nashville, TN 37232-2675 USA. E-mail: arthur.fleischer{at}vanderbilt.edu

Objective. The purpose of this study was to describe patterns seen on 2- and 3-dimensional color Doppler sonographic depiction of intratumoral vessels and to correlate these patterns to histopathologic findings in an attempt to assess their clinical importance. Methods. We conducted a retrospective analysis of 26 patients with ovarian masses and intratumoral abnormalities in whom standard 2- and 3-dimensional color Doppler sonography was performed. Results. Two- and 3-dimensional color Doppler sonography depicted several patterns of vascularity within ovarian masses. These included masses with vascularity confined to the wall or loculus and those with central versus peripheral vascularity. The presence of central intratumoral vascularity had a high positive predictive value (90%) for malignancy. Conversely, the absence of intratumoral vascularity had a high negative predictive value (96%). Conclusions. Three-dimensional color Doppler sonography is helpful in depicting overall vessel density and branching patterns within an intratumoral abnormality. This technique seems to be useful in distinguishing benign from malignant ovarian masses.

Key Words: color Doppler sonography • ovarian masses • papillary excrescences • 3-dimensional sonography • tumor vessels

Abbreviations: CDS, color Doppler sonography • 3D, 3-dimensional • 2D, 2-dimensional