Scientific publications

Contribution of power Doppler blood flow mapping to gray-scale ultrasound for predicting malignancy of adnexal masses in symptomatic and asymptomatic women

Alcázar JL [SP], Guerriero S, Laparte C, Ajossa S, Jurado M.
Department of Obstetrics and Gynecology, Clinica Universitaria de Navarra, University of Navarra, Pamplona, Spain

Magazine: European Journal of Obstetric, Ginecology and Reproductive Biology

Date: Mar 1, 2011

Gynaecology and Obstetrics

OBJECTIVE
To determine the contribution of power Doppler blood flow mapping to gray-scale ultrasound for predicting malignancy of adnexal masses in symptomatic and asymptomatic women.

STUDY DESIGN
One thousand and ninety-four women with adnexal mass were included. Patients were divided into three groups according to clinical complaints: asymptomatic (group A), patients with symptoms non-suspicious of ovarian cancer (group B) and patients with symptoms suspicious of ovarian cancer (group C). All patients underwent transvaginal power Doppler ultrasound prior to surgery. Any mass in which the echo architecture at B-mode ultrasound was not highly suggestive of benign histology was categorized as questionable. In these cases power Doppler was performed as the second step. Definitive histological diagnosis was used as the standard reference. Sensitivity, specificity, positive likelihood ratio (+LR) and negative likelihood ratio (-LR) were calculated for B-mode diagnosis and B-mode plus Doppler in each group.

RESULTS
In group A, B-mode was significantly more sensitive (98.1%) than Doppler ultrasound (91.3%) (p<0.01). In group B Doppler ultrasound (97.0%) was more specific than B-mode ultrasound (92.2%) (p<0.001). In group C Doppler ultrasound (84.0%) was more specific than B-mode ultrasound (68.0%) (p<0.001). Positive LR was significantly higher after Doppler evaluation in all groups (30.5 vs 12.8 in group A, 33.2 vs 12.8 in group B and 6.0 vs 3.1 in group C).

CONCLUSIONS
The diagnostic performance of B-mode and power Doppler ultrasound is different depending on patients' complaints.

CITATION  Eur J Obstet Gynecol Reprod Biol. 2011 Mar;155(1):99-105

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