Diagnostic value of contrast-enhanced ultrasonography in the characterization of ovarian tumors

L. M. Sconfienza, N. Perrone, A. Delnevo, F. Lacelli, C. Murolo, N. Gandolfo, G. Serafini

Research output: Contribution to journalArticle

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Abstract

Introduction: Vascularity influences the characteristics of gynecologic tumors observed with direct imaging techniques that reveal the macrovascular component of these lesions (color and power Doppler) and with indirect imaging involving the administration of contrast agents to examine the microcirculation and interstitial perfusion (contrast-enhanced computed tomography [CT] and magnetic resonance [MR] imaging). The purpose of this study was to determine whether contrast-enhanced ultrasonography (CEUS) of ovarian lesions provides useful information that cannot be obtained with conventional US. Materials and methods: We used CEUS to assess 72 nonspecific adnexal lesions in 61 patients. CEUS was performed with a 4.8-ml bolus of a second-generation ultrasonographic contrast agent and dedicated imaging algorithms. For each lesion, B-mode morphology, CEUS morphology, and time/intensity curves were evaluated. Results: In 8/61 cases (13.1%) CEUS offered no additional morphovascular information. In 38/61 cases (62.3%), it provided additional information that did not modify the management of the lesion, and in 15/61 cases (24.6%) it gave additional information that modified the management of the lesion. Malignant lesions were characterized by significantly shorter times to peak enhancement (11.9. ± 3.1 s vs 19.8. ± 4.0 s p<0.01) and significantly higher peak intensity (24.7. ± 4.2 dB vs 17.8. ± 3.3 dB p<0.01) compared with benign lesions. Conclusions: CEUS improves diagnostic confidence in the characterization of liquid-corpuscular lesions where conventional US is inconclusive. CEUS can be proposed as a valid alternative to CT and MR. However, information obtained by CEUS influences the therapy in a limited percentage of cases (24.6%).

Original languageEnglish
Pages (from-to)9-15
Number of pages7
JournalJournal of Ultrasound
Volume13
Issue number1
DOIs
Publication statusPublished - Mar 2010

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Ultrasonography
Neoplasms
Contrast Media
Tomography
Information Management
Microcirculation
Magnetic Resonance Spectroscopy
Color
Perfusion
Magnetic Resonance Imaging

Keywords

  • Adnexal masses
  • Contrast-enhanced ultrasound
  • Ovarian cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Internal Medicine

Cite this

Diagnostic value of contrast-enhanced ultrasonography in the characterization of ovarian tumors. / Sconfienza, L. M.; Perrone, N.; Delnevo, A.; Lacelli, F.; Murolo, C.; Gandolfo, N.; Serafini, G.

In: Journal of Ultrasound, Vol. 13, No. 1, 03.2010, p. 9-15.

Research output: Contribution to journalArticle

Sconfienza, L. M. ; Perrone, N. ; Delnevo, A. ; Lacelli, F. ; Murolo, C. ; Gandolfo, N. ; Serafini, G. / Diagnostic value of contrast-enhanced ultrasonography in the characterization of ovarian tumors. In: Journal of Ultrasound. 2010 ; Vol. 13, No. 1. pp. 9-15.
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abstract = "Introduction: Vascularity influences the characteristics of gynecologic tumors observed with direct imaging techniques that reveal the macrovascular component of these lesions (color and power Doppler) and with indirect imaging involving the administration of contrast agents to examine the microcirculation and interstitial perfusion (contrast-enhanced computed tomography [CT] and magnetic resonance [MR] imaging). The purpose of this study was to determine whether contrast-enhanced ultrasonography (CEUS) of ovarian lesions provides useful information that cannot be obtained with conventional US. Materials and methods: We used CEUS to assess 72 nonspecific adnexal lesions in 61 patients. CEUS was performed with a 4.8-ml bolus of a second-generation ultrasonographic contrast agent and dedicated imaging algorithms. For each lesion, B-mode morphology, CEUS morphology, and time/intensity curves were evaluated. Results: In 8/61 cases (13.1{\%}) CEUS offered no additional morphovascular information. In 38/61 cases (62.3{\%}), it provided additional information that did not modify the management of the lesion, and in 15/61 cases (24.6{\%}) it gave additional information that modified the management of the lesion. Malignant lesions were characterized by significantly shorter times to peak enhancement (11.9. ± 3.1 s vs 19.8. ± 4.0 s p<0.01) and significantly higher peak intensity (24.7. ± 4.2 dB vs 17.8. ± 3.3 dB p<0.01) compared with benign lesions. Conclusions: CEUS improves diagnostic confidence in the characterization of liquid-corpuscular lesions where conventional US is inconclusive. CEUS can be proposed as a valid alternative to CT and MR. However, information obtained by CEUS influences the therapy in a limited percentage of cases (24.6{\%}).",
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AB - Introduction: Vascularity influences the characteristics of gynecologic tumors observed with direct imaging techniques that reveal the macrovascular component of these lesions (color and power Doppler) and with indirect imaging involving the administration of contrast agents to examine the microcirculation and interstitial perfusion (contrast-enhanced computed tomography [CT] and magnetic resonance [MR] imaging). The purpose of this study was to determine whether contrast-enhanced ultrasonography (CEUS) of ovarian lesions provides useful information that cannot be obtained with conventional US. Materials and methods: We used CEUS to assess 72 nonspecific adnexal lesions in 61 patients. CEUS was performed with a 4.8-ml bolus of a second-generation ultrasonographic contrast agent and dedicated imaging algorithms. For each lesion, B-mode morphology, CEUS morphology, and time/intensity curves were evaluated. Results: In 8/61 cases (13.1%) CEUS offered no additional morphovascular information. In 38/61 cases (62.3%), it provided additional information that did not modify the management of the lesion, and in 15/61 cases (24.6%) it gave additional information that modified the management of the lesion. Malignant lesions were characterized by significantly shorter times to peak enhancement (11.9. ± 3.1 s vs 19.8. ± 4.0 s p<0.01) and significantly higher peak intensity (24.7. ± 4.2 dB vs 17.8. ± 3.3 dB p<0.01) compared with benign lesions. Conclusions: CEUS improves diagnostic confidence in the characterization of liquid-corpuscular lesions where conventional US is inconclusive. CEUS can be proposed as a valid alternative to CT and MR. However, information obtained by CEUS influences the therapy in a limited percentage of cases (24.6%).

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