الفهرس 
Anatomical ConceptsOnly 14 pages are availabe for public view
 |  | from | 199 |  |  |
| | | from | 199 | | |
Abstract
Transvaginal ultrasonographic characterization of ovar¬ian lesions by gray-scale has been proved to be feasible. By using different scoring systems based on visualization of the inner wall irregularities, the wall thickness, the presence of thick septations or solid components, evaluation of the echgenicity of the lesion, and analysis of the distal shadowing, identification of the ovarian malignancy has become more accurate.
Introduction of color-coded flow studies represents another diagnostic modality that if added to morpholo¬gical evaluation of the ovarian lesions by gray-scale may improve the diagnostic capability for ovarian malignancies. Color Doppler examination of flow velo¬city and the resistance to blood flow allows identifica¬tion of fast-growing tumoral capillaries. Since these newly formed vessels are devoid of the muscular layer, the downstream resistance measured by color flow determinations such as resistance index (RI) and pulsatility index (PI) is low and can be potentially used to predict ovarian malignancy.
Three-dimensional ultrasound is a new, emerging technology that provides additional information for the evaluation of ovarian tumors. Three dimensional power Doppler imaging itself improves the specificity of 2 DPD examination in defining the morphologic and vascular characteristics of ovarian lesions, regarding ovarian tumors.
The new 3DPD angiography with vascular index calculations combined with VOCAL, turned out to be a promising approach. It was found out that the potential role of this technique was predicting ovarian malignancy in complex vascularized adnexal masses that show central vessel distribution by assessing the vascularization of a suggestive area of a given tumor. This technique focused on complex vascularized adnexal masses because it will be useless in simple cystic mass or complex masses without flow, given that the probability of malignancy in the latter is known to be low. It was found out that a complex mass with detectable blood flow with solid areas or thick papillary projection should be categorized as malignant or very highly suggestive. The result of vas¬cularity measured by 3D vascular indices (VI,FI, and VFL) was significantly higher in cases of ovarian cancers compared with normal ovaries.
The conclusion is that three-dimensional Power Doppler ultrasonography is a reliable advanced non-invasive technique for diagnosis and evaluation of adnexal masses. But it needs adequate experience, training and expensive updated ultrasound machines