Doppler ultrasound findings in tubo-ovarian infectious complex

Ten women with tubo-ovarian infectious complex caused by pelvic inflammatory disease were investigated with vaginal Doppler sonography during the acute and healing phase of the infection. Doppler velocity waveforms were quantitated by the resistance index (RI) and pulsatility index (PI). A low resistance blood flow was found at the margin of the infectious complex. An RI' value < 0.5 was detected in 6 patients in the acute or subacute phase of infection. The severity of the infection as determined by C-reactive protein values was inversely correlated to RI and PI. The process of angioneogenesis is speculated to be responsible for this increased flow. The tubo-ovarian infectious process must be remembered in the differential diagnosis, when an adnexal mass with low resistance blood flow is found in the ultrasound examination.