Role of ultrasonography in diagnosis of adnexal masses

Background
Adnexal masses are considered one of the most common disorders in gynecology. Ultrasound remains the most widely used imaging modality to differentiate benign from malignant adnexal masses.


Patients and methods
This prospective study was conducted upon 50 female patients with 56 adnexal lesions. All patients were evaluated by either transabdominal ultrasonography, transvaginal ultrasonography, or both. All patients were evaluated by gray-scale ultrasound. Color Doppler examination was performed in certain cases with solid components. This study was approved by the Ethics Committee, and all patients gave their informed written consent before inclusion in the study. The radiological and histopathological results were collected then statistically analyzed.


Results
Our study showed that ultrasound had a sensitivity of 85.7% and a specificity of 90.5% with an overall accuracy of 89.3% in differentiation between benign and malignant lesions. The most significant ultrasound parameters suggesting malignant criteria of adnexal masses in our study were thick wall more than 3 mm, thick papillary projection, and thick septae more than 3 mm on gray-scale ultrasound, resistive index less than 0.5, and central distribution of vessels at color Doppler.


Conclusion
Ultrasound is recommended to be a very useful highly diagnostic and a reliable modality with good sensitivity and specificity for the diagnosis of adnexal masses.