Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 1 , ISSUE 2 ( April-June, 2007 ) > List of Articles


Sonographic Diagnosis of Ovarian Masses

Kohkichi Hata

Keywords : Ultrasonography,ovarian masses,morphological scoring systems,color Doppler imaging with pulsed Doppler spectral analysis,multivariate logistic regression analysis,pattern recognition

Citation Information : Hata K. Sonographic Diagnosis of Ovarian Masses. Donald School J Ultrasound Obstet Gynecol 2007; 1 (2):20-29.

DOI: 10.5005/jp-journals-10009-1095

License: CC BY-NC 4.0

Published Online: 01-06-2008

Copyright Statement:  Copyright © 2007; The Author(s).


Transabdominal ultrasonography was initially used for the investigation of overt abdominal swellings and much later for the detection of early ovarian cancer in asymptomatic women. The technique was undoubtedly of value for detecting transient, persistent and overt ovarian cysts. Subsequently, the resolving power of pelvic ultrasonography was increased substantially by the advent of transvaginal probes. This revolutionary development was first applied to systemic studies of overt ovarian masses in patients awaiting surgery. Over the past decade, several ultrasound-based morphological scoring systems, color Doppler parameters, logistic regression models have been proposed and tested in order to try to predict the histology of ovarian tumors. On prospective testing, no standard criterion has been published. Therefore, it is important for each operator to establish their own criteria based on individual recognition potential.

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  1. Characteristics of persistent ovarian masses in asymptomatic women. Br J Obstet Gynaecol 1989;96:1384-91.
  2. Transvaginal color flow imaging: a possible new screening technique for ovarian cancer. Br Med J 1989;299:1367-70.
  3. Tumors in the lower pelvis as imaged by vaginal sonography. Gynecol Oncol 1990;37:224-9.
  4. Classification of ovarian lesions by high-frequency transvaginal sonography. J Clin Ultrasound 1990;18:359-63.
  5. Transvaginal sonographic characterization of ovarian disease: evaluation of a new scoring system to predict ovarian malignancy. Obstet Gynecol 1991;78:70-6.
  6. A morphology index based on sonographic findings in ovarian cancer. Gynecol Oncol 1993;51:7-11.
  7. Transvaginal ultrasonographic characterization of ovarian masses with an improved, weighted scoring system. Am J Obstet Gynecol 1994;170:81-5.
  8. The value of detection of normal ovarian tissue (the ‘ovarian crescent sign’) in the differential diagnosis of adnexal masses. Ultrasound Obstet Gynecol 2004;23:63-7.
  9. Evaluation of adnexal masses with transvaginal color ultrasound. J Ultrasound Med 1991;10:295-7.
  10. Assessment of ovarian tumor vascularity with transvaginal color Doppler sonography. J Ultrasound Med 1991;10:563-8.
  11. Differentiating malignant from benign ovarian tumors with transvaginal color flow imaging. Obstet. Gynecol 1992;79:159-62.
  12. Transvaginal Doppler ultrasound with color flow imaging in the diagnosis of ovarian cancer. Obstet Gynecol 1992;79:163-7.
  13. Trans- vaginal color Doppler imaging for hemodynamic assessment of reproductive tract tumors. Int J Gynecol Obstet 1991;36:301-8.
  14. A critical evaluation of transvaginal Doppler studies, transvaginal sonography, magnetic resonance imaging, and CA 125 in detecting ovarian cancer. Obstet Gynecol 1992;80:922-6.
  15. Validity of pulsatility and resistance indices in classification of adnexal tumors with transvaginal color Doppler ultrasound. Ultrasound Obstet Gynecol 1992;2:338-44.
  16. Ovarian morphology, endocrine function and intra-follicular blood flow during the peri-ovulatory period. Hum Reprod 1991; 6:319-24.
  17. A comparison of intratumoral indices of blood flow velocity and impedance for the diagnosis of ovarian cancer. Ultrasound Med Biol 1996;22:837-43.
  18. Intratumoral peak systolic velocity as a new possible predictor for detection of adnexal malignancy. Am J Obstet Gynecol 1995;172:1496-500.
  19. Doppler ultrasound assessment and serum cancer antigen 125 in the diagnosis of ovarian tumors. Int J Gynecol Obstet 2005;91:146-50.
  20. Ultrasonography and color Doopler-based triage for adnexal masses to provide the most appropriate surgical approach. Am J Obstet Gynecol 2005;192:401-6.
  21. Gynecol Oncol 2003;91:46-50.
  22. Prediction analyses for binary data. In Miller RG, Efron B, Brown BWJ, Moses LE (Eds): Biostatistics Casebook. New York: John Wiley & Sons 1980;pp 3-18.
  23. Songraphic prediction of malignancy in adnexal masses using multivariate logistic regression analysis. Ultrasound Obstet Gynecol 1997;10:561-7.
  24. Sonographic prediction of malignancy in adnexal masses using an artificial neural network. Br J Obstet Gynecol 1999;106:21-30.
  25. A Comparison of methods for preoperative discrimination between malignant and benign adnexal masses: the development of a new logistic regression model. Am J Obstet Gynecol 1999;181:57-65.
  26. Prospective evaluation of logistic regression models for the diagnosis of ovarian cancer. Obstet Gynecol 2000;96:75-80.
  27. Subjective assessment of adnexal masses with the use of ultrasonography: an analysis of interobserver variability and experience. Ultrasound Obstet Gynecol 1999;13:11-6.
  28. Prospective evaluation of adnexal masses with endovaginal gray-scale and duplex and color Doppler US: Correlation with pathologic findings. Radiology 1994;191:63-7.
  29. Prospective cross-validation of Doppler ultrasound examination and gray-scale ultrasound imaging for discrimination of benign and malignant pelvic masses. Ultrasound Obstet Gynecol 1999;14:273-83.
  30. Comparison of ‘pattern’ and logistic regression models for discrimination between benign and malignant pelvic masses; a prospective cross validation. Ultrasound Obstet Gynecol 2001;18:357-65.
  31. Use of morphology to characterize and manage common adnexal masses. Best Pract Res Clin Obstet Gynaecol 2004;18:71-89.
  32. Ultrasound Obstet Gynecol 2000;16:395-8.
  33. Transvaginal color blood fow imaging of the periovulatory follicle. Fertil Steril 1993;60:433-8.
  34. The diagnosis of endometriomas using colour Doppler energy imaging. Hum Reprod 1998;13:1691-5.
  35. Three-dimensional ultrasound and power Doppler improve the diagnosis of ovarian lesions. Gynecol Oncol 2000;76:28-32.
  36. Three-dimensional ultrasound power Doppler improves the diagnostic accuracy for ovarian cancer prediction. Gynecol Oncol 2001;82:40-8.
  37. Sonographic depiction of intratumoral vascularity with 2- and 3-dimensional color Doppler techniques. J Ultrasound Med 2005;24:533-7.
  38. Comparison of 2-dimensional and 3-dimensional power-Doppler imaging in complex adnexal masses for the prediction of ovarian cancer. Am J Obstet Gynecol 2005;192:809-12.
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