Color and pulsed Doppler sonography, gray-scale imaging, and serum CA 125 in the assessment of adnexal disease.
OBJECTIVE
To compare color and pulsed Doppler sonography with gray-scale ultrasound imaging and serum CA 125 levels in establishing accurate preoperative diagnoses of adnexal masses.


METHODS
Medical records of 109 patients referred with preexisting adnexal lesions were reviewed retrospectively by comparing preoperative ultrasonic data (gray-scale imaging and color and pulsed Doppler findings) with serum CA 125 levels.


RESULTS
Eighty-three masses were removed surgically, confirming seven malignancies and 76 benign tumors, and 26 masses were followed; 15 regressed and 11 persisted. Color and pulsed Doppler sonography showed the highest sensitivity, followed by gray-scale imaging, whereas serum CA 125 levels revealed the highest specificity in distinguishing malignant from benign adnexal tumors. All three methods had high negative predictive values (96-100%), whereas only serum CA 125 had a positive predictive value greater than 50%.


CONCLUSIONS
Color and pulsed Doppler sonography, which demonstrate a tumor angiogenic activity, are as accurate as gray-scale imaging in the assessment of adnexal lesions. Together with serum CA 125 marker levels, they produce high negative predictive values, providing reassurance that an adnexal mass is benign.
Predanic
M
M
Department of Obstetrics and Gynecology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA.
Vlahos
N
N
Pennisi
J A
JA
Moukhtar
M
M
Aleem
F A
FA
D000291:Adnexal Diseases / Q000097:blood* / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D018617:Ultrasonography, Doppler, Pulsed
D018394:CA-125 Antigen