الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
SUMMARY & CONCLUSION
SUMMARY AND CONCLUSION
Ovarian tumors are common in women. Many efforts have been carried out to improve the accuracy of sonography in discriminating benign from malignant lesions. The introduction of color and pulsed Doppler ultrasonography into gynecological use inspired a lot of research work in this field for several years.
The aim of this work was to determine the diagnostic accuracy of color Doppler ultrasound in differentiating benign and malignant ovarian lesions and to compare such results with those found at histopathological diagnosis.
This study included 200 patients with ovarian lesions diagnosed clinically or by ultrasonography. After clinical examination, TVS was done for all cases. In addition TAS was done for 16 cases with large pelviabdominal masses which were out of the limited field of view of the vaginal probe. After observing all gray scale features, color Doppler was superimposed on the gray scale image to assess the flow characteristics and measure the Doppler indices (PI and RI).
The most discriminating gray-scale and Doppler features for the different lesions were evaluated. Regarding ovarian masses, the most discriminating gray scale features were the presence of solid parts, the occurrence and thickness of septa, the presence of papillae and presence of intraperitoneal fluid. The most distinguishing Doppler features were the location and arrangement of vessels (central or peripheral) related to the mass. The best Doppler indices cut off values were 0.96 and 0.4 for PI and RI respectively. The sensitivity and specificity for gray scale
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SUMMARY & CONCLUSION
ultrasound were 100% and 71.05%, and for Doppler ultrasound were 66.67% and 84.85% respectively.
Combination of gray-scale and Doppler improved the diagnostic accuracy to 85%.
The use of gray-scale ultrasonography in the evaluation of adenxal lesions is highly sensitive (100%), but it has low specificity (71.05%) due to high false +ve results. Color Doppler imaging has lower sensitivity (66.67%) but higher specificity (84.85%) than gray-scale ultrasonography in differentiating benign from malignant ovarian lesions as Doppler imaging could help in differentiating cystic echogenic or solid hypovascularized elements from solid hypervascularized tissues in ovarian masses, thus decreasing the number of malignant false positive cases and increasing the diagnostic accuracy to (85%).
Hence, gray-scale ultrasonography is a good screening test and color Doppler ultrasonography is a good confirmatory test.
So, the combination of gray-scale sonography and color Doppler sonography achieves high diagnostic accuracy in preoperative assessment of ovarian masses.