Preoperative diagnosis of ovarian tumors using pelvic contrast-enhanced sonography.
OBJECTIVE
The purpose of this study was to assess the feasibility of using a contrast agent for the sonographic examination of adnexal tumors and identify discriminating parameters in the preoperative diagnosis of malignant tumors.


METHODS
We conducted a prospective descriptive monocenter study that analyzed validated echographic criteria and parameters of the enhancement curve obtained by sonographic contrast agent injection. Patients included were referred for a second opinion after the discovery of a suspicious ovarian image. The final diagnosis was reached after surgery and an anatomopathologic examination.


RESULTS
Fifty-two tumors were analyzed. Morphologic and Doppler criteria analyses were conducted as described in the literature. The significant parameters of the enhancement curve were the time-intensity curve total area and the duration of activity of the contrast agent during the first phase of decay (P < .002). The performance of the contrast agent was lower than that of the examiner's subjective diagnosis, with an area under the receiver operating characteristic curve (AUC) of 0.78 versus 0.80. When borderline tumors were eliminated, there was an inversion of this, with an AUC of 0.85 versus 0.73. The inclusion of contrast results in the examiner's diagnosis in the context of a bivariate model comparing malignant and borderline tumors with benign tumors provided an AUC of 0.88.


CONCLUSIONS
Contrast-enhanced sonography improves preoperative diagnosis of ovarian tumors parameters. The significant parameters of the enhancement curve were significantly different for malignant and benign tumors. Borderline tumors contribute to a reduction of the discriminating capacity of the contrast agent.
Veyer
Léonard
L
Department of Obstetrics and Gynecology, Hôpital Bretonneau, 2 Boulevard Tonnellé, 37044 Tours Cedex 1, France. l.veyer@yahoo.fr
Marret
Henri
H
Bleuzen
Aurore
A
Simon
Emmanuel
E
Body
Gilles
G
Tranquart
François
F
D000328:Adult; D000368:Aged; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging*; D010743:Phospholipids; D011300:Preoperative Care; D011446:Prospective Studies; D013459:Sulfur Hexafluoride; D018608:Ultrasonography, Doppler
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride