The role of Doppler examination in evaluating the ovarian pathology

E. Brătilă, C.B. Coroleucă, C.A. Coroleucă, D.E. Comandașu, C. Mehedințu, R. Bohîlțea, M. Cîrstoiu, M. Mitran, C. Berceanu

Rezumat: The role of diagnostic ultrasound in evaluating ovarian tumors remains undeniable. The ultrasound examination is important in assessing the benign or malignant character of the ovarian mass. Ultrasound allows the evaluation of prognostic parameters and helps individualizing the oncologic treatment. In the absence of a screening program for ovarian cancer, most ovarian tumors are identified by chance. In the study International Ovarian Tumor Analysis (IOTA) there have been developed a series of simple rules for the morphological characterization of ovarian masses. The criteria used to describe an ovarian malignancy are irregular solid tumor, ascites, at least 4 papillary structures, multiloculated solid tumor with the largest diameter over 100 mm and the presence of increased Doppler flow. The criteria used to describe benign ovarian tumors are unilocular cyst, presence of solid component with a maximum diameter less than 7 mm, posterior shadowing, multilocular tumor with regular contour, without increased Doppler flow. Simple rules can be used to characterize 75% of ovarian tumors (benign or malignant). Ovarian tumor evaluation by an expert is required when the mass can not be classified using the simple rules. Simple rules and logistic regression models can be used to evaluate premenopausal patients. Doppler is used to objectify movement in tumors. Pulsed Doppler is used to highlight the resistance and pulsatility index in the peritumoral circulation and intracystic formations. Doppler exam data does not bring significant diagnostic data in terms of benign / malignant differentiation, but improves the confidence level of the examiner regarding the characterization of tumors.
Cuvinte cheie: ovarian pathology, ultrasonography, Doppler examination, imagistic diagnosis.