Adnexal Masses in Perimenopausal Women: How Effective is Color Flow Mapping and Pulse Doppler Waveform Studies in detecting Malignancy Preoperatively?

Objective: This prospective study was undertaken to assess the sensitivity and specificity of color flow mapping and pulse Doppler waveform in identifying malignancy preoperatively in adnexal masses in perimenopausal women. Materials and methods: A total of 100 cases with adnexal masses in perimenopausal women were scanned, underwent color flow mapping and pulsed Doppler waveform studies. These cysts were divided into three groups according to their ultrasound appearance – cystic, mixed cystic and solid. All the adnexal mases were removed surgically and sent for histopathological study. Results: The sensitivity and specificity of color flow mapping in identifying malignant ovarian tumors was 63.6 and 87.0% respectively. In the case of solid cysts, color flow mapping identified all malignant tumors. But, color flow mapping missed malignancies in cystic and mixed cystic masses. To improve detection rates, we used Doppler waveform studies and used resistance index less than 0.4 as the indicator of malignancy and found overall sensitivity and specificity of 90.9 and 92.3%, which was higher than that of color flow mapping. Conclusion: To conclude ultrasonic color flow mapping and pulse Doppler waveform studies used preoperatively on adnexal masses in perimenopausal women are widely available, performed rapidly and relatively easily, cost-effective and a reliable noninvasive method to predict malignancy preoperatively.