Three-dimensional ultrasound studies of normal and abnormal ovaries

Sammanfattning: The aims of this work were: 1) to estimate the number of follicles, ovarian volume and power Doppler vascular indices and their changes with age using three-dimensional (3D) transvaginal grey-scale and power Doppler ultrasound in asymptomatic women of fertile age either with natural menstrual cycles or using combined oral contraceptives, and 2) to determine whether tumour vascularity, assessed by 3D power Doppler ultrasound, can help discriminate between benign and malignant ovarian tumours. A group of 303 gynaecologically asymptomatic women, aged 20–39 years with normal menstrual cycles (NMC) and another group of 213 women aged 20–39 years using combined oral contraceptives (COC) were examined using two-dimensional (2D) and 3D transvaginal ultrasound once between cycle day 4 and 8. Ovarian volume and the number of antral follicles were found to decrease with age, while no unequivocal changes in vascular indices were seen in women with NMC. In women using COC the number of antral follicles also decreased with age. The ovarian volume and the number of follicles were determined for different age groups, and these results can be used as reference data. A group of women with ovarian tumours (n=106) was examined using 2D and 3D transvaginal ultrasound. Tumour vascularization was assessed using 3D power Doppler ultrasound in the whole tumour and in a 5-cm3 spherical sample in the most vascularized part of the tumour. A logistic regression model with only grey-scale ultrasound variables (size of the largest solid component, wall irregularity, mean diameter of the lesion) was created to predict malignancy. The flow index in the 5-cm3 sample and the branching of vessels in the whole tumour provided additional information to the grey-scale model, but the diagnostic performance was only slightly improved.