Background: Adnexal masses are a common clinical problem in gynecology. Most adnexal masses are benign, but few of them are malignant. An accurate diagnosis is essential for adequate management. There is a possibility to make a distinction between benign and malignant adnexal masses using two-dimensional grayscale ultrasound (2D-US) and color Doppler ultrasound, which are the best imaging techniques for that purpose.
Objective: To review current state-of-art of 3D/4D ultrasound in assessing ovarian masses.
Materials and methods: Narrative review of literature published from 1995 to 2017 using 3D/4D ultrasound for assessing adnexal masses masses.
Results: Three-dimensional ultrasound (3D-US) has become a routine practice in many gynecologic ultrasound laboratories because it overcomes the limitations of two-dimensional ultrasound (2D-US). This technique allows a surface rendering of the internal aspect of the cyst\'s wall. It can also present the masses in new different ways, such as “inversion mode” or “silhouette mode” or it can represent the vascular tree of the tumor using a 3D reconstruction, or even allowing a unique way for estimating the amount of vessels within the tumor or a part of the tumor. The reproducibility of 3D-US performed by different sonographers has been assessed in several studies. All of them have found that this technique is reproducible among different observers. The main limitations of all the studies are a few cases compared to the high prevalence of malignancies.
Conclusion: 3D-US probably have better diagnostic performance than 2D-US assessing malignancies in adnexal masses. However, better-designed studies are needed to draw definitive conclusions.