Prospective evaluation of adnexal masses with endovaginal gray-scale and duplex and color Doppler US: correlation with pathologic findings

To assess the reliability of gray-scale and color and duplex Doppler ultrasound (US) in making a specific diagnosis of malignant ovarian tumor.

Forty-two women with 50 adnexal masses underwent endovaginal and color and duplex Doppler US. Morphologic characteristics were evaluated with endovaginal US, and flow velocity patterns were evaluated with color and duplex Doppler US. The results were compared with pathologic findings.

At pathologic examination, 40 masses (80%) were benign, one (2%) was borderline malignant, and nine (18%) were malignant. Endovaginal US enabled correct diagnosis of 38 of the 40 benign masses (95%) and all nine malignant masses (100%). Color and duplex Doppler US enabled correct diagnosis of 33 benign masses (82%) and seven malignant masses (78%).

Because there is an overlap in the resistive index (RI) values of benign and malignant masses, RI values alone cannot be relied on. Combining the detailed analysis of internal architectural appearance with the flow velocity patterns obtained at pulsed Doppler US increases the specificity in the diagnosis of adnexal masses.