Objectives

Results:The presence of a notch in the Doppler shift spectrum was significantly more common in extraovarian than ovarian masses (P < 0.0001). Notches were particularly common in tubal lesions and tubo-ovarian abscesses (51% and 68%), less common in peritoneal and paraovarian cysts (29% and 15%) and least common in ovarian lesions (3%). Multivariate logistic regression showed that extraovarian origin of a mass was the only variable to explain the presence of a notch in the Doppler shift spectrum of tumor vessels. Conclusion: Even though the presence of a notch in the Doppler shift spectrum cannot conclusively distinguish between ovarian and extraovarian adnexal lesions, or between lesions involving or not involving the tube, assessing Doppler shift spectra for the presence of a notch may contribute useful diagnostic information in cases where the ultrasound examiner is uncertain about the diagnosis. Purpose: The authors assessed the characteristics of benign and malignant solid breast tumors in harmonic three-dimensional (3D) power Doppler imaging and proposed decision models to classify benign and malignant breast tumors. Materials and methods: A total of 86 malignant and 97 benign harmonic 3D power Doppler US images were analyzed. All the harmonic 3D power Doppler images were obtained using a Voluson730 US system (GE Healthcare, Zipf, Austria) equipped with a RSP 6-12 transducer and tissue harmonic imaging modalities. Imaging analysis was performed using the Virtual Organ Computeraided Analysis (VOCAL)-imaging program. Histogram indices, the vascularization index (VI), flow index (FI) and vascularization-flow index (VFI), were calculated for the intra-tumor and for shells with an outside thickness of 3 mm surrounding the breast tumors. The receiver operating characteristic (ROC) curves were calculated to estimate the diagnostic performances. P46.04 Results:The results revealed that the choice of decision model comprised the parameters of patient age, intra-tumor VI, and tumor volume to classify benign and malignant breast tumors. The area under the ROC curve (Az) was 0.910, accuracy was 81.4%, and sensitivity and specificity were 81.4% and 81.4%, respectively. The parameter intra-tumor VI was the choice for all of the histogram indices in differentiating between malignant and benign lesions. Conclusion: The decision model, which was composed of patient age, tumor volume and intra-tumor VI, and a cut-off value for intra-tumor VI at the upper end of patient age and tumor volume, was recommended in clinical application. Key words: harmonic three-dimensional power Doppler, vascularization index, flow index, vascularization-flow index. P46.05The sonographic detection of adenomyosis in patients with endometrial ablation failure Objective: This is a descriptive study of sonographic findings of adenomysosis pre-and postoperatively in patients who fail endometrial ablation.Study Design: This is a retrospective review of patients who underwent endometrial ablation for abnormal uterine bleeding and pre-operative pelvic so...