الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Evaluation of ovarian lesions is of particular importance in gynecological practice. Two main problems need answers: discrimination of benign and malignant ovarian masses and choice of the appropriate surgical treatment if necessary.
A majority of ovarian masses are non neoplastic cysts. However, twenty-five percent of ovarian neoplasms are malignant. For this reason, surgical removal of a suspected ovarian neoplasm is the standard procedure. In most institutions, the type of surgery performed (laparoscopy vs. laparotomy) depends on the probability of malignancy. Advances in ultrasonography have led to frequent incidental detection of an early ovarian cancer at initial scanning. Several attempts have been made to distinguish accurately an early stage ovarian malignancy from questionable ovarian lesions on the basis of grey scale ultrasound and/or colour Doppler features. Although colour Doppler ultrasound could provide clinically useful information about ovarian tumor vascularity, the presence of an overlap in blood flow parameters between malignant and benign ovarian tumors is the main element of the debate regarding attempts to differentiate ovarian tumors accurately.
Recent technological advances such as 3D volume acquisition and 3D power Doppler may have clinical utility in the early identification of abnormal ovarian vascularity and architecture.
Application of currently available 3D imaging modalities on patients with “positive” standard ultrasound tests represent an innovation as compared with previous ovarian cancer screening trials. A secondary screening test based on morphologic and Doppler parameters assessed by 3D ultrasound, 3D power Doppler, and, in most doubtful cases, contrast-enhanced 3D power Doppler ultrasound may improve the accuracy of screening for ovarian cancer in high risk populations.
Contrast enhanced transvaginal sonography is a new technique that seems to be quite accurate in sonographic detection of early stage of ovarian cancer. Its clinical use is currently under investigation in several centers worldwide. It is hoped that this technique can be an effective means to detect early stage ovarian cancer alone or combined with serum testing.