Borderline cystic tumors of the ovary: gray-scale and color Doppler sonographic findings.
OBJECTIVE
The aim of the study was to determine the value of gray-scale and color Doppler sonography in distinguishing borderline cystic tumors (BCTs) from benign cysts and malignant tumors of the ovary.


METHODS
The gray-scale and color Doppler sonographic features of 383 ovarian lesions in 374 nonpregnant women were retrospectively studied. Sonography was performed transvaginally for all but 7 lesions, which were imaged suprapubically. All of the lesions were surgically resected via laparoscopy or laparotomy.


RESULTS
The histopathologic diagnoses were 27 BCTs, 35 ovarian carcinomas, and 321 benign cysts. Sonography diagnosed 24 (89%) of 27 BCTs as malignant lesions. Patients with BCTs, were younger than those with ovarian cancer (p < 0.001). BCTs showed intracystic papillae in 17 cases (63%), diffuse internal echoes in 11 (41%), intracystic septa in 8 (30%), a heterogeneous echo pattern in 7 (26%), and a solid pattern in 4 (15%). BCTs showed blood flow in 24 cases (89%) and lower pulsatility and resistance indices (RI) compared with benign lesions (p < 0.001 for both). Multivariate analysis revealed intracystic papillae as the only independent predictor of BCTs (p < 0.001).


CONCLUSIONS
When a cystic mass has papillae, this is the only abnormal finding detected by gray-scale transvaginal sonography, and color Doppler imaging shows low RI values within the mass, a BCT should be suspected.
Pascual
M Angela
MA
Department of Obstetrics and Gynecology, Institut Universitari Dexeus, Universitat Autónoma de Barcelona, Paseo Bonanova, 89-91, 08017 Barcelona, Spain.
Tresserra
Francisco
F
Grases
Pedro J
PJ
Labastida
Ramon
R
Dexeus
Santiago
S
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010048:Ovarian Cysts / Q000000981:diagnostic imaging*; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color