title: Transvaginal power Doppler findings in laparoscopically proven acute pelvic inflammatory disease.
abstract: OBJECTIVE
  To evaluate the usefulness of power Doppler transvaginal sonography (TVS) in the diagnosis of pelvic inflammatory disease (PID) and to assess the diagnostic reliability of specific sonographic findings.
  
  
  METHODS
  The study population consisted of 30 women admitted for suspected acute PID. The reference group consisted of 20 women with proven hydrosalpinx formation.
  
  
  METHODS
  Both conventional TVS and power Doppler TVS were performed. All patients with suspected acute PID underwent laparoscopy in order to confirm the diagnosis. Sonographic criteria described earlier were used for the diagnosis of acute PID. Power Doppler was used to assess the vascularity of any adnexal mass.
  
  
  RESULTS
  Laparoscopy confirmed the diagnosis of PID in 20 (67%) of the 30 women with clinically suspected acute PID. Specific TVS findings, including wall thickness > 5 mm, cog-wheel sign, incomplete septa, and the presence of cul-de-sac fluid, discriminated women with acute PID from the control women with hydrosalpinx formation. Power Doppler TVS revealed hyperemia in all women with acute PID, but in only two women with hydrosalpinx (P = 0.01). Pulsatility indices were significantly lower in the acute PID group than in the control group (pulsatility index 0.84 +/- 0.04 vs. 1.50 +/- 0.10; P < 0.01).
  
  
  CONCLUSIONS
  Power Doppler TVS was 100% sensitive and 80% specific in the diagnosis of PID (overall accuracy 93%). Specific sonographic landmark findings and power Doppler findings augment the clinical diagnosis of PID and allow simple classification of the severity of the disease.
authors: Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland.
authors: P
authors: P
authors: Molander
authors: J
authors: J
authors: Sjöberg
authors: J
authors: J
authors: Paavonen
authors: B
authors: B
authors: Cacciatore
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D000292:Pelvic Inflammatory Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011673:Pulsatile Flow; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal