Kinetics of a US contrast agent in benign and malignant adnexal tumors.
OBJECTIVE
To evaluate the effects of a microbubble contrast agent on the power Doppler ultrasonographic (US) examination of adnexal tumors, with a special focus on the timing of the transit of the microbubble bolus.


METHODS
Seventy patients who were suspected of having ovarian tumors were examined preoperatively with contrast material-enhanced US. Images obtained during a 5-minute examination were stored digitally, and the behavior of the contrast agent was evaluated objectively with measurement of the time-dependent image intensity at the region of interest with a computer program. A time-intensity curve in each case was derived and analyzed. The Mann-Whitney U test was used to compare intensity changes and tumor parameters in benign and malignant adnexal tumors.


RESULTS
Both the baseline and maximum power Doppler intensities, as well as the absolute and relative (percent) rise in intensity, were significantly higher (P <.001) in malignant as compared with benign tumors. The arrival time was shorter (17.5 vs 22.5 seconds; P =.005) and the duration of contrast agent effect was longer (190.4 vs 103.6 seconds; P <.001) in malignant tumors than they were in benign tumors. The area under the time-intensity curve was significantly greater in malignant tumors compared with that in benign tumors (P <.001).


CONCLUSIONS
After microbubble contrast agent injection, malignant and benign adnexal lesions behave differently in degree, onset, and duration of Doppler US enhancement.
Ordén
Maija-Riitta
MR
Department of Obstetrics and Gynecology, Kuopio University Hospital, Puijonlaaksontie 2, 70210 Kuopio, Finland. maija-riitta.orden@kuh.fi
Jurvelin
Jukka S
JS
Kirkinen
Pertti P
PP
D000291:Adnexal Diseases / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000493:pharmacokinetics*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008863:Microspheres; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging; D011134:Polysaccharides / Q000493:pharmacokinetics*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D018608:Ultrasonography, Doppler / Q000379:methods*
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508