Gray scale ultrasonography, color doppler and laparoscopy in evaluating pelvic adnexal masses

In this study 46 patients with adnexal masses were evaluate. Of clinical, sonographic, Doppler and laparoscopic examinations were compared after correlation with histopathological examination. Clinical examination had the same sensitivity as ultrasound in evaluating malignant lesions. Sensitivity and specificity for diagnosis of malignant ovarian masses were 100%, 71.05% and 66.67%, 84.85% for gray-scale and Doppler respectively. Combination of gray-scale and Doppler improved the diagnostic accuracy to 85%. Laparoscopy had the highest sensitivity [100%] and specificity [97.06%] in evaluation of adenxal masses and in differentiating ovarian from other adenxal lesions. So, it is considered as the best diagnostic modality for diagnosis of doubtful cases of adenxal lesions and differentiating the anatomical origin of such masses. The most characteristic gray-scale sonographic criteria for diagnosis malignant varian tumour were presence of solid component, papillary projections, thick septa and ascites. Neovascularization with peripheral and central blood vessels and low Doppler indices were important Doppler features of malignant lesions. A cut off value of 0.96 for PI and 0.4 for RI gave the most reasonable sensitivity and specificity for discriminatin benign and malignant lesions

Value of doppler waveform velocities, the biophysical profile scoring, maternal thromboxane and prostacyclin levels as indicators of severity of preeclampsia and perinatal outcome

This study included forty cases who were divided into two groups: Group I included twenty cases [control group] and group II included twenty cases [preeclamptic group]. For all cases, the maternal plasma levels of thromboxane B2, 6 keto-prostaglandin F1 alpha, Doppler study of both uterine and umbilical arteries, modified biophysical scoring value, Apgar score and neonatal birth weight were all done to know the relative importance of these investigations in determining both the severity of preeclampsia and the perinatal outcome. Both thromboxane B2 and umbilical artery Doppler A/B ratio were increased significantly only in cases with severe preeclampsia. So, both could be used as indicators of severity of preeclampsia. They could reflect also the fetal condition. Uterine artery Doppler A/B ratio was increased significantly in both mild and severe cases of preeclampsia. So, it has a limited value in reflecting the fetal condition or severity of preeclampsia. The biophysical profiles scoring showed significant reduction in preeclamptic cases having an umbilical artery Doppler A/B ratio more than 3 if compared with those with ratios less than 3. This indicated that biophysical profile is a valuable tool for evaluation of the fetal condition in utero with easy detection of fetal hypoxia. This could be added to the other advantages as being simple, noninvasive, rapid and inexpensive test. The umbilical artery Doppler study could be used as confirmatory, not a substituting, test to the biophysical profile for evaluation of the fetal condition