Blood flow in functional cysts and benign ovarian neoplasms in premenopausal women

To assess the value of transvaginal color Doppler sonography in the differentiation of functional cysts from benign ovarian neoplasms in premenopausal women, 100 premenopausal women with the diagnosis of adnexal mass were enrolled in a prospective study. All patients underwent transvaginal color Doppler sonography during the follicular phase. We evaluated 107 masses. Tumor volume and morphology were assessed, as were tumor blood flow location, the number of vessels, the resistive and pulsatility indices, and the peak systolic velocity. Patients were followed up after 8 to 10 weeks by transvaginal sonography. Functional cysts were considered when spontaneous resolution occurred. Surgery was performed if a tumor enlarged or persisted after two scans. Thirty-nine (36.5%) cysts regressed spontaneously and 68 (63.5%) were removed surgically. Seven of the latter were follicular or luteal cysts and were considered to be functional cysts. No carcinoma was found. Arterial blood flow was detected in 28 (60.8%) functional cysts and in 42 (68.8%) benign neoplasms (P = 0.3446). The vessels were located peripherally in 27 (94.6%) functional cysts and in 37 (88.1%) benign neoplasms (P = 0.2226). No differences were found between functional cysts and benign neoplasms in mean resistive index (0.65, 95% confidence interval: 0.59 to 0.71 versus 0.64, 95% confidence interval: 0.60 to 0.69), mean pulsatility index (1.47, 95% confidence interval: 1.17 to 1.84 versus 1.57, 95% confidence interval: 1.26 to 1.86), number of vessels (1.1, 95% confidence interval: 0.7 to 1.3 versus 1.4, 95% confidence interval: 1.1 to 1.8), and peak systolic velocity (28.6 cm/s, 95% confidence interval: 24.7 to 34.2 versus 24.9 cm/s, 95% confidence interval: 21.6 to 28.3). We concluded that transvaginal color Doppler sonography is not useful to discriminate between functional ovarian cysts and benign ovarian neoplasms in premenopausal women.