18th World Congress on Ultrasound in Obstetrics and Gynecology Oral communication abstracts Objectives: To determine fetal and neonatal outcome in referrals with isolated abdominal fetal calcifications. Methods: We report 24 cases of prenatally diagnosis isolated abdominal calcifications referred to our centre over the period 1997–2007. The management included detailed fetal ultrasound imaging, maternal TORCH analysis, parental and fetal cystic fibrosis mutations analysis, fetal karyotype, and infectious investigations in amniotic fluid. Neonatal examination and postnatal ultrasound findings were collected and follow-up was obtained. Results: In 16 cases, abdominal calcifications were limited to one single organ (7 into the liver, 1 into the bowel, 1 into the spleen, 6 cases close to stomach and 1 behind the liver). In 2 cases, TORCH screening was abnormal (1 case of CMV and 1 toxoplasmosis) and in 1 case ureplasma urealyticum was found in amniotic fluid. Calcifications size remained stable during pregnancy for all cases excepted one with spontaneous antenatal resolution. In 8 cases, multiple abdominal calcifications were present. CMV infection was found in 2 cases and in 1 case Ureaplasma urealyticum was found in amniotic fluid. Postnatal outcome was complicated by neonatal peritonitis for one newborn and by chorioamnionitis ureaplasma for another one. For the others, postnatal outcome was uneventful and abdominal isolated calcifications were confirmed in postnatal US examination. No abnormal karyotype and no genetic abnormality of parental and fetal CF screen was evidenced. Conclusions: Abdominal isolated calcifications are frequently found at the 2 nd trimester US. Our experience shows that when they are isolated to one single organ, neonatal outcome is uneventful but when they are present in multiple localisations, there is an increased risk of neonatal complications, as meconial peritonitis or chorioamniotitis. The prenatal management should include maternal TORCH screen and US Follow-up and amniotic fluid sampling should be discussed OC162 Presence of acoustic streaming in different types of adnexal masses C. Van Holsbeke 1 , S. Guerriero 2 , V. Van Belle 3 , A. Czekierdowski 4 , W. Ombelet 1 , L. Valentin 5 , D. Fischerova 6 , D. Paladini 7 , Z. Jingzhang 8 , D. Jurkovic 9 , T. Bourne 10 , D. Timmerman 11 1 Ziekenhuis Oost-Limburg, Genk, Belgium, 2 Department of Obstetrics and Gynaecology, University of Cagliari, Cagliari, Italy, 3 Department of Electrical Engineering, Leuven, Belgium, 4 Department of Gynecology, Medical University in Lublin, Lublin, Poland, 5 Department of Obstetrics and Gynecology, Malm ¨ o University Hospital, Lund University, Malm ¨ o, Sweden, 6 Department of Obstetrics and Gynecology, Prague, Czech Republic, 7 Universit ` a degli Studi di Napoli ‘‘Federico II’’ (University Federico II of Naples), Naples, Italy, 8 Ultrasound Department, Chinase PLA General Hospital, Beijing, China, 9 Department of Obstetrics and Gynaecology, King’s College Hospital, London, United Kingdom, 10 Gynaecological Ultrasound and Minimal Access Unit, London, United Kingdom, 11 University Hospitals Leuven, Leuven, Belgium Aim: Acoustic streaming is the movement of fluid in a cyst due to energy transfer from the US wave. A previous study reported that absence of acoustic streaming could be a typical characteristic of an endometrioma (Eoma). The aim is to examine which type of adnexal masses demonstrate acoustic streaming. Methods: IOTA phase 2 included patients with an adnexal mass in 19 different centers. Patients were scanned following the same standardized US protocol. The primary outcome was the histological diagnosis. More than 40 demographic and US variables were mandatory, but the evaluation of acoustic streaming was optional. Results: 1940 patients were included, acoustic streaming was evaluated in 1128 cases of which 868 (77%) were benign and 260 (23%) malignant. Acoustic streaming was absent in 1022 (91%) masses and present in 105 (9%) of which 82 (78%) were benign and 23 (22%) malignant. Masses that demonstrated acoustic streaming were 26 Eomas, 21 serous cystadenofibromas, 15 mucinous cystadenofibromas, 10 teratomas,, 3 functional cysts, 3 hydrosalpinges,, 2 simple cysts, 2 rare benign tumors, 12 invasive carcinomas, 10 borderline tumors and 1 metastatic tumor. Masses with acoustic streaming were larger (median for the maximum diameter of the lesion was 88 mm versus 66 mm) and more often had low level echogenicity of the cyst content (63/105 (60%) versus 184/1022 (18%)). The presence of acoustic streaming to discriminate between Eomas and other types of adnexal masses reached a sensitivity of 89.7% (228/254), a specificity of 9.03% (79/874), LR+ 0.986 and LR- 1.14. Eomas with acoustic streaming were larger (median of max diameter lesion 66 mm versus 54.5 mm) and more often had low level echogenicity (30% versus 7%). Conclusion: This study confirms our previous report that acoustic streaming can also be present in Eomas and therefore can not be used as an ultrasound variable to exclude Eomas. It is more often present in large adnexal masses with low level echogenicity. OC163 Transvaginal ultrasound guided needle aspiration in the management of patients with simple ovarian cysts M. Momtaz , A. Ebrashy, M. M. Aboulghar, A. AlKateb, A. Z. AlSheikha Fetal Medicine Unit, Cairo University, Cairo, Egypt Objectives: To evaluate the effectiveness, safety and recurrence rate of transvaginal ultrasound guided aspiration of simple ovarian cysts. Methods: Two hundred and twelve women with ovarian cysts were referred for transvaginal aspiration between January 2000 and December 2006 following an ultrasound diagnosis of a suspected benign ovarian cyst. Inclusion criteria were: cysts measuring 5–10 cm in diameter, persistent cysts after 2 months of follow up/contraceptive pills, pain, high risk for surgery and/or anesthesia and patients scheduled for IVF/ICSI procedures. Multi-locular cysts, cysts with thick walls (> 3 mm), suspected Dermoid cysts, pregnancy, ascites and other signs of malignancy, high CA125 and associated pelvic lesions requiring surgery were excluded. A total of one hundred and sixty five (77.8%) cysts met the criteria and were included in the study. A 18G/20G × 25 cm needle was used for transvaginal aspiration using an endocavity probe (Medison Accuvix and Voluson 530D, Seoul, South Korea) under intravenous anesthesia. Aspirated fluid was sent for cytologiy and microbiolgy analysis. All cases were followed up at 1, 6 and 12 months. Results: Two cases (1.2%) needed immediate surgery for suspected internal bleeding and another two (1.2%) for failure of drainage. Out of the 161 cysts (97.5%) successfully aspirated, 24 (14.9%) recurred within 6 months and another 11 (6.8%) within one year. Twelve of the 35 recurrent cases had repeat transvaginal aspiration, 10 were given medical treatment and the remaining 13 had surgical intervention. No cases had other post-operative complications and none developed ovarian malignancy. Conclusion: Transvaginal ultrasound guided aspiration of simple ovarian cysts is an alternative to surgery in properly selected cases especially those who are not suitable for surgery/anesthesia and before IVF/ICSI. The complication rate (2.4%) and recurrence rate (21.7%) are acceptable and comparable to endoscopic ovarian cystectomy. 296 Ultrasound in Obstetrics & Gynecology 2008; 32: 243–307