Preoperative evaluation of pelvic tumors by Doppler and three-dimensional sonography.
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.
Kurjak
A
A
Department of Obstetrics and Gynecology, Medical School, University of Zagreb, Sveti Duh Hospital, Croatia.
Kupesic
S
S
Sparac
V
V
Bekavac
I
I
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D003287:Contrast Media; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005185:Fallopian Tube Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D009389:Neovascularization, Pathologic; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D011300:Preoperative Care; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*; D018615:Ultrasonography, Doppler, Color
D003287:Contrast Media