Document Detail

Transvaginal color Doppler sonography in adnexal masses: which parameter performs best?
MedLine Citation:
PMID:  8883314     Owner:  NLM     Status:  MEDLINE    
The aim of this study was to establish which of several commonly used parameters performs best in the evaluation of adnexal masses by transvaginal color Doppler sonography. A total of 79 adnexal masses in 73 consecutive patients were included in the study. There were 43 (58.9%) premenopausal and 30 (41.1%) postmenopausal patients. The median age was 45 years (range 20-78 years). The parameters compared were: number of vessels detected in each tumor, tumor vessel location (central vs. peripheral), peak systolic velocity (PSV), lowest resistance index (RIlowest), mean resistance index (RImean), lowest pulsatility index (PIlowest) and mean pulsatility index (PImean). Receiver operating characteristic (ROC) curves were plotted to analyze the test performance of the parameters, except for tumor vessel location, and to estimate the best cut-off value of the parameters studied to differentiate between malignant and benign tumors. Definitive histopathological diagnosis was obtained in every case and used as the 'gold standard'. There were 20 (25.3%) malignant and 59 (74.7%) benign masses. Color Doppler signals were detected in 100% of the malignant masses (20 out of 20) and 74.6% (44 out of 59) of the benign masses, and the difference was found to be statistically significant (p < 0.001). Tumor vessel location was central in 18 out of 20 (90%) malignant masses, whereas it was peripheral in 39 out of 44 (88.6%) benign masses. ROC analysis showed that the best cut-off values for number of vessels, PSV, RIlowest, RImean, PIlowest and PImean were three vessels, 25 cm/s, 0.45, 0.55, 0.90 and 1.50, respectively. However, for all these parameters except RIlowest, there was a considerable overlap between benign and malignant tumors, with a high false-positive rate. In conclusion, in our experience, the parameters that performed best were the RIlowest with a cut-off value of 0.45 (sensitivity 100%; false-positive rate 11.4%) and central tumor vessel location (sensitivity 90%; false-positive rate 11.4%).
J L Alcázar; M L Ruiz-Perez; T Errasti
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  8     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1997-01-23     Completed Date:  1997-01-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  114-9     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Clínica Universitaria de Navarra, School of Medicine, University of Navarre, Pamplona, Spain.
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MeSH Terms
Adnexal Diseases / pathology,  physiopathology,  ultrasonography*
Blood Flow Velocity
Diagnosis, Differential
Middle Aged
Observer Variation
ROC Curve
Retrospective Studies
Sensitivity and Specificity
Ultrasonography, Doppler, Color*

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