Doppler ultrasonography of the pelvis

TVS has brought the pelvic organs closer to us than ever before. Color Doppler probes have exposed small vessels that could not be seen with real-time technique alone, and pulsed Doppler is becoming an important adjunct in many physiologic and pathologic states. Vascular changes of the ovary and uterus during the menstrual cycle are now being followed during infertility protocols, are being investigated to determine the viability of an early pregnancy, and may increase our confidence in the diagnosis of an ectopic pregnancy in a few selected cases. Waveform analysis may be useful in discriminating benign from malignant uterine masses, and additional work in the diagnosis of pelvic thrombophlebitis and ovarian torsion is anticipated. Color Doppler sonography has an important role to play in the diagnosis of early ovarian cancer. A large multicenter trial is ongoing in this country to determine if there is a characteristic PI that will determine whether an adnexal mass is benign. While much of this work is preliminary, TV-CDS has tremendous potential in the assessment of pelvic disease.