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The ‘lead vessel’: a vascular ultrasound feature of metastasis in the ovaries
Author(s) -
Testa A. C.,
Mancari R.,
Di Legge A.,
Mascilini F.,
Salutari V.,
Scambia G.,
Ferrandina G.
Publication year - 2008
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.5251
Subject(s) - medicine , ovary , ovarian carcinoma , metastasis , ovarian cancer , ultrasound , radiology , pathology , cancer
Abstract Objective To investigate, in a series of metastatic and primary invasive ovarian lesions examined by color Doppler, the prevalence of a main peripheral vessel penetrating into the central part of the ovarian mass with a tree‐shaped morphology, defined as the ‘lead vessel’. Methods This was a retrospective study of 31 patients with histopathologically confirmed metastatic involvement of the ovary and 106 patients with confirmed primary invasive ovarian carcinoma, who had undergone standardized ultrasound examination, with established definitions of ultrasound characteristics. We retrieved sonographic images and videoclips, focusing on the detection of the lead vessel. Results The presence of the lead vessel was detected in 11/31 (35.4%) metastatic ovarian tumors, and in only two (0.01%) cases of primary ovarian carcinoma ( P = 0.0001). At color Doppler analysis, metastatic ovarian lesions were characterized by significantly lower pulsatility index ( P = 0.0001) and resistance index ( P = 0.0001) values, and significantly higher peak systolic velocity ( P = 0.0002) and time‐averaged maximum velocity ( P = 0.04) values, when compared with primary ovarian carcinomas. The lead vessel was detected in 11/21 (52%) solid metastatic lesions and in no cases of multilocular or multilocular‐solid lesions ( P = 0.008). Conclusion The lead vessel is a novel sonographic feature of vascular morphology in solid ovarian metastases. The more frequent observation of this feature in metastatic ovarian tumors compared with primary invasive ovarian carcinomas warrants further investigation in order to explore its potential role in the diagnosis of metastatic ovarian masses. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.