title: Contrast-enhanced transvaginal sonography of benign versus malignant ovarian masses: preliminary findings.
abstract: OBJECTIVE
  The aim of this prospective study was to evaluate differences in contrast enhancement and contrast enhancement kinetics in benign versus malignant ovarian masses with pulse inversion harmonic transvaginal sonography.
  
  
  METHODS
  Seventeen consecutive patients with 23 morphologically abnormal ovarian masses (solid or cystic with papillary excrescences, focally thickened walls, or irregular solid areas) smaller than 10 cm received a microbubble contrast agent intravenously while undergoing pulse inversion harmonic transvaginal sonography. The following parameters were assessed in all tumors: detectable contrast enhancement, time to peak enhancement (wash-in), peak contrast enhancement, half wash-out time, and area under the enhancement curve. Tumor histologic analysis was used to distinguish benign from malignant ovarian tumors.
  
  
  RESULTS
  Fourteen benign masses and 9 malignancies were studied. There was a statistically significant difference in the peak enhancement (mean +/- SD, 23.3 +/- 2.8 versus 12.3 +/- 3.9 dB; P < .01), half wash-out time (139.9 +/- 43.6 versus 46.3 +/- 19.7 seconds; P < .01), and area under the enhancement curve (2012.9 +/- 532.9 versus 523.9 +/- 318 seconds(-1); P < .01) in malignant masses compared with benign disease. There was no statistically significant difference in the time to peak enhancement (26.1 +/- 6.3 versus 24.9 +/- 7.6 seconds; P = .07).
  
  
  CONCLUSIONS
  Overall, our data showed a significant difference in the contrast enhancement kinetic parameters between benign and malignant ovarian masses.
authors.affiliation: Department of Radiology, Vanderbilt University Medical Center, RR-1213 MCN, 1161 21st Ave N, Nashville, TN 37232-2675, USA. arthur.fleischer@vanderbilt.edu
authors.forename: Arthur C
authors.initials: AC
authors.lastname: Fleischer
authors.forename: Andrej
authors.initials: A
authors.lastname: Lyshchik
authors.forename: Howard W
authors.initials: HW
authors.lastname: Jones
authors.forename: Marta
authors.initials: M
authors.lastname: Crispens
authors.forename: Mary
authors.initials: M
authors.lastname: Loveless
authors.forename: Rochelle F
authors.initials: RF
authors.lastname: Andreotti
authors.forename: Phillip K
authors.initials: PK
authors.lastname: Williams
authors.forename: David A
authors.initials: DA
authors.lastname: Fishman
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001943:Breast Neoplasms / Q000473:pathology*; D003287:Contrast Media; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D005260:Female; D005466:Fluorocarbons; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007700:Kinetics; D045423:Microbubbles; D008875:Middle Aged; D010049:Ovarian Diseases / Q000175:diagnosis; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D010053:Ovary / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D015203:Reproducibility of Results; D018615:Ultrasonography, Doppler, Color / Q000379:methods
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren