title: Usefulness of transabdominal real-time sonoelastography in the evaluation of ovarian lesions: preliminary results.
abstract: OBJECTIVE
  We aim to evaluate and describe the tissue elasticity characteristics of various ovarian lesions with sonoelastography.
  
  
  METHODS
  35 patients (age range 16-85 years; mean age 40.8 years) underwent sonoelastography and later MRI. Histopathological confirmation of all lesions was carried out, except eight of endometriomas and six of septated cysts which were confirmed on MRI and follow-up ultrasonography. Strain ratios and elastogram patterns were recorded. Lesions were classified into three groups (Group 1: cystic lesions, Group 2: benign tumours and Group 3: malignant lesions) and findings were compared between groups for both observers. Interobserver agreement was analyzed. Optimal cut-off values for strain ratios were achieved with receiver operating characteristic curve analysis.
  
  
  RESULTS
  Ovarian endometriomas and complex cystic lesions were observed hard on elastograms with high strain ratios, and malignant lesions were observed mostly soft with very small strain ratios. Benign tumours had average tissue stiffness, observed harder than the malignant lesions, and strain ratios ranged from 4 to 14. The differences in patterns and strain ratios between groups were statistically significant (p < 0.05 for both observers).
  
  
  CONCLUSIONS
  Our study revealed that malignant ovarian lesions have softer tissue property than benign lesions and cystic lesions in terms of elastogram patterns and strain ratios.
  
  
  CONCLUSIONS
  Most ovarian lesions contain solid and cystic parts which make the malignant and benign lesions look similar on imaging modalities. Using real-time sonoelastography as an adjunct to other imaging modalities may improve the differentiation of malignant ovarian lesions from benign lesions.
authors.affiliation: 1 Department of Radiology, School of Medicine, Pamukkale University, Denizli, Turkey.
authors.forename: Duygu
authors.initials: D
authors.lastname: Herek
authors.affiliation: 2 Department of Gynecology and Obstetrics, School of Medicine, Pamukkale University, Denizli, Turkey.
authors.forename: Aysun
authors.initials: A
authors.lastname: Karabulut
authors.affiliation: 1 Department of Radiology, School of Medicine, Pamukkale University, Denizli, Turkey.
authors.forename: Kadir
authors.initials: K
authors.lastname: Agladioglu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004715:Endometriosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D010048:Ovarian Cysts / Q000000981:diagnostic imaging*; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging*; D012372:ROC Curve; D055815:Young Adult