The differential diagnosis of adnexal masses still constitutes a major clinical challenge. B-mode ultrasonography is the most used imaging technique and it is the base for this differential diagnosis with acceptable results in terms of sensitivity but a relatively high false positive rate for predicting ovarian cancer. The role of pulsed Doppler remains controversial and seems to be not reproducible in clinical practice. In the last years, new approaches and technologies such as 2D Power-Doppler ultrasound for tumor vessel mapping, contrast-enhanced ultrasound and 3D ultrasound have been proposed for improving our ability to discriminate between benign and malignant adnexal masses. In this review I aim to evaluate critically recent literature of these new technologies in order to show how they work, what they offer and what can be expected in a very next future.
Keywords: Adnexal masses, Power-Doppler ultrasound, contrast agent enhancement ultrasound, three-dimensional ultrasound
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