title: Combination of 2- and 3-dimensional contrast-enhanced transvaginal sonography for diagnosis of small adnexal masses.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of the combination of 2-dimensional (2D) and 3-dimensional (3D) contrast-enhanced sonography in discriminating between benign and malignant small adnexal masses.
  
  
  METHODS
  Selected patients were evaluated with both 2D and 3D contrast-enhanced sonography after conventional sonography before undergoing any surgery. Time-intensity curves for 2D contrast-enhanced sonography were constructed by using contrast-enhanced sonographic software. A vascular perfusion characteristic analysis was achieved by 2D and 3D contrast-enhanced sonography. Results were finally verified by surgery.
  
  
  RESULTS
  Forty-seven cases of benign and 10 cases of malignant small adnexal masses were discovered. Significant differences in perfusion patterns, time-intensity curve shapes for 2D contrast-enhanced sonography, grayscale contrast-enhanced sonography, and blood flow imaging on 3D contrast-enhanced sonography were observed between benign and malignant masses (P< .05). Two-dimensional contrast-enhanced sonography, 3D contrast-enhanced sonography, parallel combination of 2D and 3D contrast-enhanced sonography, and serial combination of 2D and 3D contrast-enhanced sonography all reached diagnostic sensitivity of 100% for discriminating benign from malignant masses, whereas specificity values were 61.7%, 63.8%, 68.1%, and 57.4%, respectively. Areas under the receiver operating characteristic curves were 0.809, 0.819, 0.840, and 0.787.
  
  
  CONCLUSIONS
  Two-dimensional contrast-enhanced sonography is of high value in distinguishing malignant from benign small adnexal masses; 3D contrast-enhanced sonography provides richer and more useful information for evaluation of these masses. Diagnostic sensitivity of 100% can be achieved when using a serial combination of 2D and 3D contrast-enhanced sonography, although specificity needs further improvement.
authors.affiliation: Departments of Ultrasonography (R.H., H.X., Y.F., L.G., H.L.) and Echocardiography (Y.M.), First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Hu
authors.affiliation: Departments of Ultrasonography (R.H., H.X., Y.F., L.G., H.L.) and Echocardiography (Y.M.), First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Xiang
authors.affiliation: Departments of Ultrasonography (R.H., H.X., Y.F., L.G., H.L.) and Echocardiography (Y.M.), First Affiliated Hospital of Xinjiang Medical University, Urumqi, China. muyuming1234@126.com xianghong65@126.com.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Mu
authors.affiliation: Departments of Ultrasonography (R.H., H.X., Y.F., L.G., H.L.) and Echocardiography (Y.M.), First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Yuling
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Departments of Ultrasonography (R.H., H.X., Y.F., L.G., H.L.) and Echocardiography (Y.M.), First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Linaer
authors.initials: L
authors.lastname: Gu
authors.affiliation: Departments of Ultrasonography (R.H., H.X., Y.F., L.G., H.L.) and Echocardiography (Y.M.), First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging*; D010743:Phospholipids; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D047368:Tumor Burden; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D014621:Vagina
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
keywords: adnexal masses; contrast-enhanced sonography; differential diagnosis; gynecologic ultrasound