Perfusion Imaging of Ovarian Masses with Contrast-enhanced Ultrasonography

Objective To determine the perfusion features of ovarian masses and their diagnostic value. Methods Contrast-enhanced ultrasonography (CEUS) of 81 ovarian masses were confirmed by surgical pathology. Time-intensity curves of perfusion were obtained for the interest areas of ovarian mass. CEUS perfusion parameters were estimated, including rise time (RT), time to peak (TTP), peak intensity (PI), time from peak to one half (TTH) and area under the curve (AUC). Repeatability of those parameters was tested. Differences in the perfusion parameters were tested between benign and malignant masses, between tumor and non-tumor masses, between different differentiated and stages of ovarian cancers, between cancers with and without lymph-node metastases, and between primary and metastatic cancers. Receive operating characteristic (ROC) curve analyses were performed to determine the cutoff values of perfusion parameters for discriminating cancer from benign ovarian masses. Results Good intra-observer repeatability was reached in the five perfusion parameter measurements. PI, TTH and AUC increased significantly in ovarian cancer and tumor compared with benign and non-tumor masses (P<0.05). PI, TTH and AUC were effective parameters in diagnosing ovarian cancer. AUC had the highest diagnostic effectiveness, with a sensitivity of 87.3% and a specificity of 80.8% at the cutoff value of 877 dB·s. There were no differences in the parameters between different differentiated and stages of ovarian cancers, between cancers with and without lymph-node metastases, and between the primary and metastatic cancers. Conclusion Malignant ovarian cancer has higher PI, TTH and AUC values in CEUS. AUC has certain value in diagnosing ovarian cancer.