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Kinetics of a US Contrast Agent in Benign and Malignant Adnexal Tumors¹

¹ From the Departments of Obstetrics and Gynecology (M.R.O.) and Clinical Physiology and Nuclear Medicine (J.S.J.), Kuopio University Hospital, Puijonlaaksontie 2, 70210 Kuopio, Finland; and Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland (P.P.K.). Received August 29, 2001; revision requested October 17; final revision received May 20, 2002; accepted June 18. Supported by the Finnish Cultural Foundation and the Research Foundations of Orion Corporation and Instrumentarium. Address correspondence to M.R.O. (e-mail: maija-riitta.orden@kuh.fi).

PURPOSE: To evaluate the effects of a microbubble contrast agent on the power Doppler ultrasonographic (US) examination of adnexal tumors, with a special focus on the timing of the transit of the microbubble bolus.

MATERIALS AND METHODS: Seventy patients who were suspected of having ovarian tumors were examined preoperatively with contrast material–enhanced US. Images obtained during a 5-minute examination were stored digitally, and the behavior of the contrast agent was evaluated objectively with measurement of the time-dependent image intensity at the region of interest with a computer program. A time-intensity curve in each case was derived and analyzed. The Mann-Whitney U test was used to compare intensity changes and tumor parameters in benign and malignant adnexal tumors.

RESULTS: Both the baseline and maximum power Doppler intensities, as well as the absolute and relative (percent) rise in intensity, were significantly higher (P < .001) in malignant as compared with benign tumors. The arrival time was shorter (17.5 vs 22.5 seconds; P = .005) and the duration of contrast agent effect was longer (190.4 vs 103.6 seconds; P < .001) in malignant tumors than they were in benign tumors. The area under the time-intensity curve was significantly greater in malignant tumors compared with that in benign tumors (P < .001).

CONCLUSION: After microbubble contrast agent injection, malignant and benign adnexal lesions behave differently in degree, onset, and duration of Doppler US enhancement.

© RSNA, 2003

Index terms: Ovary, neoplasms, 852.31, 852.32 • Ovary, US, 852.12988 • Ultrasound (US), contrast media, 852.12988 • Ultrasound (US), Doppler studies, 852.12988

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