Caractérisation des masses annexielles par échographie : place des différentes techniques

Transvaginal two-dimensional ultrasound is the first-line examination in patients referred for a suspected adnexal mass (apart from the child or the virgin patient, for whom the suprapubic examination will be used). The harmonic mode gives a better definition of the contours of the masses, reduces the repetition of echoes and thus allows an easier detection of small solid portions. Energy Doppler must always be used with transvaginal ultrasound, because it confirms the presence of a solid portion or vegetation. In contrast, the absence of a Doppler signal within an echogenic portion does not eliminate the absence of flow. Indeed, in gynaecology, the flows are very slow; therefore it is imperative to know the Doppler settings. Regarding the characterization of adnexal masses, the International Ovarian Tumor Analysis Group (IOTA) advocates the use of a common language in the examination report.