Ovary and ultrasound: from physiology to disease

Gynecological ultrasound is one of the most accurate imaging technique in clinical practice. It is characterized by minimal invasiveness, tolerability, repeatability, fast execution and low cost, changing completely the methodological approach to diagnosis of adnexal pathology, in particular those one from ovary. Vaginal ultrasonography is a practical and reliable method to monitor structural changes in the ovaries during the physiological menstrual cycle, but it allows also early detection of pathological features. Correct characterization of ovarian/adnexal masses is important for optimal patient management. The morphological features of an adnexal mass can be used to indicate the likelihood of being benign or malignant. Ultrasound diagnostic accuracy is really high in distinguishing functional ovarian cysts from organic ones, thanks to also the possibility to observe these lesions as time goes on and to study them very well with a three dimensional approach. On the contrary, differential diagnosis between benign ovarian masses and malignancy is more complex, in particular identifying borderline tumors. Pattern recognition has been shown to be superior to all other ultrasound methods (e.g. simple classification systems, scoring systems, mathematical models). However, even when ultrasound don’t make possible a diagnosis, this tool gives important information for correct management of every single case.