Purpose: Trans-vaginal US (TVUS) is a widely accepted imaging technique in the assessment of ovarian masses. The role of TVCEUS has not been completely defined. Our paper evaluates the clinical value of TVCEUS in the therapeutic program of adnexal masses.
Methods and Materials: We assessed 101 lesions in 84 patients where a prior TVUS was not diagnostic. TVCEUS was performed after endovenous injection of 4.8 ml of US contrast agent and dedicated imaging algorithms. Both TVUS and TVCEUS images were stored and assessed retrospectively by an expert radiologist and a gynaecologist, who compared TVUS and TVCEUS according to: 1. no further information; 2. new information not modifying the therapy; 3. information that significantly modify the therapeutic management. Controls were made by surgery (29), trans-vaginal biopsy (16), magnetic resonance (44) or follow up over 6 months.
Results: In 12/101 cases, TVCEUS did not add morpho-vascular information. In 56/101 cases, TVCEUS added information that did not modify the management of lesions; in 33/101 cases, TVCEUS gave information that modified the management of lesions.
Conclusions: TVCEUS was able to add further information in a limited amount of cases and in a selected population of patients but it seems to be very important in the modification of therapeutic procedures. Changing the therapeutic approach of an ovarian lesion could lead to savings in terms of time and money in the follow up of affected patients.