Francesca Lacelli MD, Abstract Co-Author: Nothing to Disclose

Luca Maria Sconfienza MD, Presenter: Nothing to Disclose

Nadia Perrone, Abstract Co-Author: Nothing to Disclose

Michela Gravano, Abstract Co-Author: Nothing to Disclose

Nicoletta G. Gandolfo, Abstract Co-Author: Nothing to Disclose

Giovanni Serafini MD, Abstract Co-Author: Nothing to Disclose

Trans-vaginal Ultrasound (TVUS) is a widely accepted imaging technique in the assessment of ovarian masses but the role of TVCEUS has not been completely defined. The purpose of our paper is to assess the clinical value of TVCEUS in the therapeutic program of adnexal masses.

We assessed 92 lesions in 75 patients where a prior TVUS was not diagnostic. TVCEUS was performed after the injection of 4.8 ml of ultrasonographic 2nd generation contrast medium and with dedicated imaging algorithms. Both TVUS and TVCEUS images were stored and assessed retrospectively by an expert radiologist and a gynaecologist, who compared TVUS vs. TVCEUS according to: 1. no further information added; 2. presence of information that does not modify the management of the lesion; 3. presence of information that modify significantly the management of the lesion. Controls were made by surgery (27), trans-vaginal biopsy (12), magnetic resonance (40) and follow up over 6 months.

In 10/92 cases, TVCEUS did not add morpho-vascular information. In 51/92 cases, TVCEUS added information that did not modify the management of the lesion; in 31/92 cases, TVCEUS was able to give information that modified the management of the lesion, in terms of surgical technique and timing, aspiration and follow up. TVCEUS improved the diagnosis in liquid corpuscolated, hemorrhagic and pseudo-solid appearance lesions and in hydrosactosalpingis. Moreover, the lack of perfusion allowed a histological diagnosis in 6 ovarian fibroids (in differential diagnosis with solid strumal tumors not composed of bundles of bland spinale cells) and 1 avascular lipoma.

TVCEUS was able to add further information in a limited amount of cases and in a selected population of patients but it seems to be very important in the modification of therapeutic procedures.

Changing the therapeutical approach of an ovarian lesion could lead to savings in terms of time and money in the follow up of affected patients.

Lacelli, F, Sconfienza, L, Perrone, N, Gravano, M, Gandolfo, N, Serafini, G, Trans-vaginal Contrast-enhanced Ultrasound (TVCEUS) and Adnexal Masses: Evaluation of Clinical Impact on the Therapeutic Management of Lesions.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6019477.html