B-mode and Power Doppler Ultrasound in Adnexsal Masses

Adnexal masses can be classified in ovarian, paraovarian or tubal. In the present review we analyzed the diagnostic performance of transvaginal ultrasonography in identifying simple ultrasonographic findings of benign adnexal pathology but also the role of color Doppler in the differential diagnoses between benign and malignant masses and in the preoperative triage. Because of many kinds of adnexal masses have usually a typical ultrasound appearance, the results of the studies present in literature showed a good and sufficient diagnostic accuracy. Unfortunately some cases with uncertain findings are present and in these cases the addition of color Doppler can be useful as demonstrated by several authors. Using the location of flow evaluated using color Doppler as main parameter a mass should be graded as malignant if flow is shown centrally within the excrescences or solid areas. The same approach should be used to triage the patients with adnexal masses to the most appropriate surgical approach with an increase of less invasive surgery.