ABSTRACT
To determine whether resistance index values obtained by color Doppler Ultrasound, Transvaginal ultrasound and the Tumor marker Tissue Polypeptide Antigen [TPA] contribute to the accuracy in diagnosis of ovarian malignancies in post - menopausal women with adnexial mass. Twenty post menopausal women with palpable adnexal mass admitted to Zagazig University Hospital were chosen where the following were done: 1. Transvaginal ultrasound. 2. Color Doppler ultrasound. 3. A blood Sample for tissue polypeptide antigen [TPA]. 4. Histopathology of the excised mass. Twenty postmenopausal women forming the study group the number of ovarian masses was 8 benign and 13 malignant with a percentage of 38.1% and 61.9% respectively [one case has bilateral mass]. Pathological confirmation was available for the 21 masses. Ascitis was present in 3 cases of malignant tumors, two patients had no detectable blood flow. Using morphologic criteria alone the sensitivity in detecting malignancy was 90% and specificity was 50% while using pulsed Doppler alone with a resistance index limit of 0.6 the sensitivity and specificity would be the same as transvaginal ultrasound. Adding TPA with both pulsed color Doppler and transvaginal ultrasound did not increase the diagnostic accuracy but help in follow up