The Use of Compression Sonoelastography in Multiparametric Ultrasound Examination in Cases of Benign Ovarian Formations

Properly diagnosed benign ovarian formations are a condition for appropriate treatment choice. Qualitative assessment of signs detected by multiparametric ultrasound, including compression elastography, is highly effective in the differential diagnosis of benign ovarian formations. Our study became especially relevant for women in the reproductive period since the correct diagnosis influenced the choice of surgical treatment in order to preserve the ovarian reserve. The detailed sonographic aspect of these formations in B-mode, Doppler mode and compression sonoelastography mode is analyzed in the article. Color Flow Mapping, power Doppler and pulsed wave Doppler were used to study blood vessels. Pulsed wave Doppler characterized blood flow quantitatively. Color Flow Mapping was used to determine vessels localization, and power Doppler was used to provide a detailed qualitative assessment of blood flow loci. Elastotype according to the Ueno scale as a qualitative feature and Strain Ratio (coefficient of deformation) as a quantitative indicator were determined for all types of benign ovarian formations. Serous and mucinous cystadenomas were found to belong to elastotypes 0 and I according to the Ueno scale, the papillary component of serous superficial papillomas was mapped as elastotype I and II, fibroids predominantly belonged to elastotype II and III, mature teratoma appertained to elastotypes IV and V. Quantitative coefficient of deformation for all benign ovarian formations ranged from 0.63 to 24.9. According to our results, ultrasound examination of ovarian formations is an accurate and highly informative method for stratification of risks in accordance with the O-RADS classification.

Adnexal Masses in Perimenopausal Women: How Effective is Color Flow Mapping and Pulse Doppler Waveform Studies in detecting Malignancy Preoperatively?

ABSTRACT Objective This prospective study was undertaken to assess the sensitivity and specificity of color flow mapping and pulse Doppler waveform in identifying malignancy preoperatively in adnexal masses in perimenopausal women. Materials and methods A total of 100 cases with adnexal masses in perimenopausal women were scanned, underwent color flow mapping and pulsed Doppler waveform studies. These cysts were divided into three groups according to their ultrasound appearance – cystic, mixed cystic and solid. All the adnexal mases were removed surgically and sent for histopathological study. Results The sensitivity and specificity of color flow mapping in identifying malignant ovarian tumors was 63.6 and 87.0% respectively. In the case of solid cysts, color flow mapping identified all malignant tumors. But, color flow mapping missed malignancies in cystic and mixed cystic masses. To improve detection rates, we used Doppler waveform studies and used resistance index less than 0.4 as the indicator of malignancy and found overall sensitivity and specificity of 90.9 and 92.3%, which was higher than that of color flow mapping. Conclusion To conclude ultrasonic color flow mapping and pulse Doppler waveform studies used preoperatively on adnexal masses in perimenopausal women are widely available, performed rapidly and relatively easily, cost-effective and a reliable noninvasive method to predict malignancy preoperatively. How to cite this article Gupta N. Adnexal Masses in Perimenopausal Women: How Effective is Color Flow Mapping and Pulse Doppler Waveform Studies in detecting Malignancy Preoperatively? J South Asian Feder Menopause Soc 2013;1(1):27-33.