Ultrasonographic Evaluation and Differentiation of Adnexal Masses with Histopathological Correlation.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 3
Abstract
Background: Adnexal mass is common among women of reproductive age group. Diagnosis of these as benign and malignant are difficult and complex. Prompt identification and treatment is essential for an unruffled life. Pelvic ultrasonography remains the mainstay for this endeavor. Advent of Doppler in combination with greyscale ultrasonography has extended the imaging ability to characterize these lesions. Aim: To evaluate efficacy of ultrasound in differentiating malignant from benign adnexal lesions. Materials and Methods: A prospective study of ultrasound evaluation was done from October 2016 to March 2018 on 95 patients. The data was used for sonomorphological characterization with Sassone Scoring for probability of malignancy and benignity. The findings were merged with doppler vascularity index to obtain an overall sonological result. The efficacy of the combined results was evaluated by postoperative histopathological results. Results: Sonomorphological evaluation detected 77% of malignant lesions. Addition of doppler identified all the malignant lesions when equated with histopathological diagnosis.One benign lesion was misdiagnosed as malignant. The PPV increased from [77.3 %] to [ 95.6% ] and diagnostic accuracy from [90.3 %] to [98.9 %] .Statistical analysis attributed P value of 0.05, hence considered to be significant. Conclusion: The present study demonstrates increase in sensitivity, specificity ,PPV and NPV in preoperative diagnosis and characterization of adnexal masses. A significant improvement of PPV and diagnostic accuracy was found on addition of doppler to greyscale ultrasound alone. Sassone scoring combined with vascular parameters can be strongly recommended to achieve better characterization and differentiation of benign and malignant adnexal masses.
Authors and Affiliations
Dr. Rinchu Santappan
Keywords
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