title: Use of the sonographic contrast medium in the study of pelvic masses: preliminary remarks.
abstract: OBJECTIVE
  To evaluate the role of intravenously injected sonographic contrast medium (CM) in characterising space-occupying pelvic lesions.
  
  
  METHODS
  Forty-seven women with palpable pelvic mass underwent color Doppler US before and after the intravenous injection of an ultrasound CM. The examination results were divided into three categories: Class I = no additional diagnostic information supplied by the contrast-enhanced examination; Class II = the use of CM facilitated the identification of vascular structures but did not significantly affect the diagnosis or the patient's subsequent diagnostic/therapeutic procedures; Class III = the information obtained significantly affected treatment decisions regarding the single patients.
  
  
  RESULTS
  After the CM injection, 9/47 (19.1%) cases were assigned to Class I, 25/47 (53.2%) to Class II, and 13/47 (27.7%) to Class III. At baseline, all 13 lesions later assigned to Class III had shown an avascular appearance or only peripheral vascularisation. This type of vascular distribution was confirmed by the contrast-enhanced study, which helped determine the haemorrhagic nature (with solid appearance) of some lesions, or support the hypothesis put forward during the baseline study, that the lesion was a poorly vascularised benign mass. This lent further support to our choice to undertake a laparoscopic surgical approach in 2 lesions, it altered our decision as to the type of surgery to be performed (laparoscopy vs. laparotomy) in 5 patients, and confirmed our intention to undertake only the follow-up in the 6 remaining cases.
  
  
  CONCLUSIONS
  The use of the sonographic CM proved clinically useful in 13/47 patients with space-occupying pelvic lesions. The most important result of this examination was its ability to confirm the nonvascular or poorly vascular component of a lesion, and therefore to suggest its benign nature.
authors.affiliation: Servizio di Radiologia, Ospedale di Pietra Ligure, Savona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Serafini
authors.forename: Nicoletta G
authors.initials: NG
authors.lastname: Gandolfo
authors.forename: Nicola
authors.initials: N
authors.lastname: Gandolfo
authors.forename: Francesca
authors.initials: F
authors.lastname: Pugliese
authors.forename: Fabio
authors.initials: F
authors.lastname: Pretolesi
authors.forename: Carlo
authors.initials: C
authors.lastname: Martinoli
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D018615:Ultrasonography, Doppler, Color
chemical_list: D003287:Contrast Media