title: Diagnostic value of contrast-enhanced ultrasonography in the characterization of ovarian tumors().
abstract: BACKGROUND
  Vascularity influences the characteristics of gynecologic tumors observed with direct imaging techniques that reveal the macrovascular component of these lesions (color and power Doppler) and with indirect imaging involving the administration of contrast agents to examine the microcirculation and interstitial perfusion (contrast-enhanced computed tomography [CT] and magnetic resonance [MR] imaging). The purpose of this study was to determine whether contrast-enhanced ultrasonography (CEUS) of ovarian lesions provides useful information that cannot be obtained with conventional US.
  
  
  METHODS
  We used CEUS to assess 72 nonspecific adnexal lesions in 61 patients. CEUS was performed with a 4.8-ml bolus of a second-generation ultrasonographic contrast agent and dedicated imaging algorithms. For each lesion, B-mode morphology, CEUS morphology, and time/intensity curves were evaluated.
  
  
  RESULTS
  In 8/61 cases (13.1%) CEUS offered no additional morphovascular information. In 38/61 cases (62.3%), it provided additional information that did not modify the management of the lesion, and in 15/61 cases (24.6%) it gave additional information that modified the management of the lesion. Malignant lesions were characterized by significantly shorter times to peak enhancement (11.9 ± 3.1 s vs 19.8 ± 4.0 s p < 0.01) and significantly higher peak intensity (24.7 ± 4.2 dB vs 17.8 ± 3.3 dB p < 0.01) compared with benign lesions.
  
  
  CONCLUSIONS
  CEUS improves diagnostic confidence in the characterization of liquid-corpuscular lesions where conventional US is inconclusive. CEUS can be proposed as a valid alternative to CT and MR. However, information obtained by CEUS influences the therapy in a limited percentage of cases (24.6%).
authors: Radiology Unit, IRCCS Policlinico San Donato, University of Milan School of Medicine, San Donato Milanese (MI), Italy.
authors: L M
authors: LM
authors: Sconfienza
authors: N
authors: N
authors: Perrone
authors: A
authors: A
authors: Delnevo
authors: F
authors: F
authors: Lacelli
authors: C
authors: C
authors: Murolo
authors: N
authors: N
authors: Gandolfo
authors: G
authors: G
authors: Serafini
keywords: Adnexal masses; Contrast-enhanced ultrasound; Ovarian cancer
references: Eur J Obstet Gynecol Reprod Biol. 1998 Jan;76(1):97-107
references: 9481556
references: Clin Obstet Gynecol. 2009 Mar;52(1):73-93
references: 19179862
references: J Radiol. 2003 Nov;84(11 Pt 1):1725-31
references: 15022984
references: AJR Am J Roentgenol. 1996 Feb;166(2):385-93
references: 8553953
references: Ultrasound Obstet Gynecol. 2008 Jan;31(1):85-91
references: 18098335
references: Ultrasound Obstet Gynecol. 2008 Jun;31(6):681-90
references: 18504770
references: Ultrasound Obstet Gynecol. 1999 Oct;14(4):273-83
references: 10586480
references: Ginekol Pol. 1999 Jun;70(6):444-9
references: 10895286
references: Radiology. 2000 Dec;217(3):803-11
references: 11110947
references: Ultrasound Obstet Gynecol. 2000 Oct;16(5):500-5
references: 11169340
references: Acta Obstet Gynecol Scand. 1994 Sep;73(8):637-41
references: 7941989
references: Int J Cancer. 2001 Oct 15;94(2):153-6
references: 11668491
references: Ultrasound Obstet Gynecol. 2008 Apr;31(4):450-6
references: 18338427
references: Ultrasound Obstet Gynecol. 2002 Dec;20(6):597-604
references: 12493050
references: Ultrasound Obstet Gynecol. 2008 Aug;32(2):210-9
references: 18636616
references: Gynecol Obstet Invest. 1994;38(3):210-2
references: 8001878
references: Ultrasound Obstet Gynecol. 2009 Aug;34(2):188-95
references: 19526595
references: Obstet Gynecol. 1998 Apr;91(4):561-7
references: 9540941
references: Ultrasound Obstet Gynecol. 2007 May;29(5):505-11
references: 17444565
references: J Clin Ultrasound. 1997 Jun;25(5):217-25
references: 9314102
references: J Ultrasound Med. 2000 Nov;19(11):783-8
references: 11065267
references: Radiology. 2003 Feb;226(2):405-10
references: 12563133
references: Lancet Oncol. 2009 Apr;10(4):308-9
references: 19341965
references: Obstet Gynecol. 2000 Sep;96(3):452-8
references: 10960641