Transvaginal color Doppler imaging for hemodynamic assessment of reproductive tract tumors

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Abstract
Transvaginal color Doppler flow imaging was carried out on 68 Japanese women (normal, 10; uterine myoma, 21; cervical carcinoma, 7; endometrial carcinoma, 10; benign ovarian tumor, 12; ovarian carcinoma, 8). Blood flow velocity waveforms were evaluated by calculation of the resistance index (RI). In 6 patients with cervical carcinoma neovascularization was evident within the cervix. In all patients with endometrial carcinoma such signs were present adjacent to and/or within the endometrium. These findings were absent in normal women and in those with myomata. There was a significant difference between the RI (0.510 ± 0.097) in patients with cervical carcinoma and in normal women (0.881 ± 0.048) in the ascending branch. In endometrial carcinoma the RI (0.535 ± 0.158) was significantly lower in the arcuate artery compared to the normal uterus (0.768 ± 0.075) and patients with uterine myoma (0.679 ± 0.131), respectively. There was no area of neovascularization in the normal ovaries. Neovascularization was confirmed in four patients with a benign ovarian tumor and in all patients with an ovarian carcinoma. A significantly lower RI was obtained in cases of ovarian carcinoma (0.503 ± 0.122) than in patients with benign ovarian tumors (0.888 ± 0.216). Transvaginal color Doppler imaging and pulsed Doppler analysis may be useful diagnostic tools to differentiate benign and malignant tumors.