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To compare two-dimensional (2D) and three-dimensional (3D) transvaginal ultrasound with magnetic resonance imaging (MRI) as the gold standard in assessment of parametrial infiltration of cervical cancer and to determine if all parts of the cervix are equally assessable with ultrasound.

Objectives: To compare two-dimensional (2D) and three-dimensional (3D) transvaginal ultrasound with magnetic resonance imaging (MRI) as gold standard in the assessment of parametrial infiltration of cervical cancer, and to determine if all parts of the cervix are equally assessable with ultrasound. Methods: Patients with histologically confirmed macroscopically evident cervical cancer were staged using FIGO criteria and underwent MRI, 2D- and 3D-ultrasound before treatment. When assessing parametrial infiltration with 3D-ultrasound and MRI, the cervix was (virtually) divided into three cylinders of equal size (cranial, middle, caudal) and each cylinder into six sectors in a clockwise manner following a consensus between radiologists and ultrasound examiners. The presence and the extent of parametrial invasion were recorded for each sector. The results for 2D-ultrasound, 3Dultrasound and MRI were compared, results being reported as percentage agreement and Kappa value. Results: 29 consecutive patients were included. The percentage agreement between 2D-ultrasound and MRI in assessing parametrial infiltration (yes or no) was 76% (kappa 0.459), that between 3Dultrasound and MRI 79% (kappa 0.508). 2D-ultrasound showed the following agreement with MRI: 90% for the ventral parametria (kappa 0.720), 72% for the right lateral parametrium (kappa 0.494), 69% for the left lateral parametrium (kappa 0.412), 58.5% for the dorsal parametria (kappa 0.017). 3D-ultrasound showed the following agreement with MRI: 62.5% for the ventral parametria (kappa 0.176), 81% for the right lateral parametrium (kappa 0.595), 70% for the left lateral parametrium (kappa 0.326), 52% for the dorsal parametria (kappa 0.132). The best agreement between 3Dultrasound and MRI was obtained for the middle cervical cylinder (agreement 76%, kappa 0.438) and the poorest agreement for the caudal cylinder (agreement 34.5%, kappa 0.125). Conclusion: 2D- and 3D-ultrasound showed similar moderate agreement with MRI.

To describe the clinical history and ultrasound findings in women with decidualized endometriomas surgically removed during pregnancy.

BACKGROUNDUnilocular-solid ovarian cysts are a rare but challenging pathology in young women, with a desire to spare their fertility. In these cases, the risks of borderline and invasive disease are around 10 and 20%, respectively. No ultrasound rule has yet demonstrated the ability to discriminate with high accuracy, a borderline tumor from a benign tumor or 'invasive tumor'. The aim of this study was to assess the predictive performance of different ultrasound parameters in differentiating benign and borderline tumors versus invasive malignant tumors in premenopausal patients with unilocular-solid ovarian masses.METHODSWomen aged ≤50 years with unilocular-solid adnexal masses with a maximum diameter ≤10 cm, undergoing surgery in our department within 3 months from ultrasound examination, were included in this retrospective study. A standardized ultrasound examination technique and predefined definitions of ultrasound characteristics were used. The results of ultrasound examination using gray scale and color Doppler were compared with the histological examination of the respective surgical specimens.RESULTSThe study included 51 patients. On histological examination, 36 (70%) lesions were classified as benign, 10 (20%) as borderline ovarian tumors and 5 (10%) as invasively malignant tumors. In receiver-operating characteristic curve analysis, the best cut-off for the largest solid component with regard to discriminating non-invasive (benign or borderline) from invasive tumors was 14 mm. A largest solid component >14 mm, the presence of papillation blood flow and the combination of the two parameters provided a sensitivity of 100% and a specificity of 63, 63 and 80%, respectively.CONCLUSIONSTransvaginal ultrasound examination seems to be able to discriminate between invasive and non-invasive tumors in the premenopausal patients with unilocular-solid adnexal masses. Because of the retrospective nature of the study, further prospective clinical trials are needed to