​Pre-operative Evaluation of Ovarian Masses with Color Doppler and its Correlation with Pathological Finding

Introduction: The management of ovarian tumors remains a common clinical gynecologic problem. The early and definitediagnosis of ovarian malignancy is of grave clinical importance. Recently, the role of color and spectral Doppler in the diagnosisof ovarian malignancy has been a subject of enormous debate.Aim: The purpose of the study was to evaluate the efficiency of color flow Doppler and its parameters with pulsatility index (PI)and resistive index (RI), to discriminate the benign and malignant ovarian masses.Methods: In 24 months period selected 100 patients, in whom adnexal mass was detected by ultrasound and had further evaluatedby Color flow Doppler at the radiology department. PI was calculated from the reproducible spectral waveforms generated fromflow central to peripheral within the mass or adjacent to the mass. The resistive index was calculated as the mean of threeconsecutive waveforms with the lowest RI. Each lesion was categorized on the basis of gray scale morphology as benign,borderline, and malignant. Other parameters such as a wall and septal thickness and echogenicity also were recorded. Theseimage-guided indices were further confirmed with histopathological findings to differentiate benign and malignant ovarian tumors.Results: Of the 100 patients 85 were benign, two were borderline, and 13 were a malignant ovarian mass with mean age 35.2,45.0, and 48.3, respectively. The threshold of PI >1 and RI >0.4 was diagnosed as benign. PI <0.8 and RI <0.4 were low andused as predictors of ovarian malignancy. Similarly, other parameters were calculated to discriminate the lesion.Conclusion: The study showed a high positive predictive value of high impedance flow in benign and predominant low impedanceflow in the malignant lesion. In the present study, fairly good specificity and sensitivity with PI <1 and the resistive index <0.4were achieved in ovarian malignancy. Color Doppler study was the diagnostic modality of choice for the patients with adnexalmass to establish the diagnosis of malignant ovarian tumors.