The power Doppler velocity index, pulsatility index, and resistive index can assist in making a differential diagnosis of primary ovarian carcinoma and Krukenberg tumors: a preliminary study.
OBJECTIVE
The aim of this study was to compare the effectiveness of transvaginal power Doppler sonography with spectral Doppler analysis as an aid in preoperatively distinguishing primary ovarian carcinoma and metastatic carcinoma to the ovary (Krukenberg tumors).


METHODS
Fifty women with ovarian disease were preoperatively examined with transvaginal power Doppler sonography. Six basic parameters were measured, including intratumoral peak systolic velocity, end-diastolic velocity, time-averaged maximum velocity, pulsatility index (PI), resistive index (RI), and velocity index (VeI). Blood flow analyses were detectable in all patients. Twelve patients with metastatic carcinoma to the ovary were classified as group 1; 38 patients with primary ovarian carcinoma were classified as group 2. Comparison of intratumoral blood flow analyses between the two groups was performed.


RESULTS
The PI, RI, and VeI were significantly lower in patients with metastatic carcinoma to the ovary than those with primary ovarian carcinoma (P < .05). There were no significant differences in the peak systolic velocity (P = .871), end-diastolic velocity (P = .508), and time-averaged maximum velocity (P = .850) between the two groups.


CONCLUSIONS
Transvaginal power Doppler sonography with spectral Doppler analysis is an effective method in evaluating intratumoral blood flow of Krukenberg tumors. Low impedance (PI, RI, and VeI) might assist us in making differential diagnoses between primary ovarian carcinoma and Krukenberg tumors according to our preliminary results.
Chen
Chih-Yao
CY
Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
Wu
Yi-Cheng
YC
Yen
Ming-Shyen
MS
Hung
Jeng-Hsiu
JH
Yuan
Chiou-Chung
CC
Chao
Kuan-Chong
KC
D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging / Q000503:physiopathology; D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000556:secondary; D018269:Carcinoma, Endometrioid / Q000000981:diagnostic imaging / Q000503:physiopathology; D018283:Cystadenocarcinoma, Papillary / Q000000981:diagnostic imaging / Q000503:physiopathology; D018284:Cystadenocarcinoma, Serous / Q000000981:diagnostic imaging / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007725:Krukenberg Tumor / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000000981:diagnostic imaging / Q000503:physiopathology; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology*; D012039:Regional Blood Flow / Q000502:physiology; D018312:Sex Cord-Gonadal Stromal Tumors / Q000000981:diagnostic imaging / Q000503:physiopathology; D018608:Ultrasonography, Doppler; D018615:Ultrasonography, Doppler, Color; D018617:Ultrasonography, Doppler, Pulsed; D014655:Vascular Resistance / Q000502:physiology*