The differential diagnosis of adnexal masses still represents a challenge in spite of the marvelous efforts
that have been made to improve the sonographically based diagnosis. There were rapid technological
advances in diagnostic ultrasonography in the last decade, with the recent development of threedimensional
power Doppler ultrasonography (3DPD).
The introduction of 3DPD has opened the possibility to characterize microvasculature of the adnexal
masses and objectively assess tumor vascularization. 3DPD allows also an objective measurement of vascularity
of a given region of interest by estimating 3 vascular indices (vascularization index [VI], flow
index [FI], and vascularization-flow index [VFI]) within such region. The aim of this review article is to
evaluate the role of 3DPD in the assessment of adnexal masses vascularity, its ability to discriminate
benign masses from malignant ones.