A Study on Validity of Ultrasonography and Magnetic Resonance Imaging in Assessment of Uterine Adnexal Masses

Abstract

Introduction: Adnexal mass lesions are common among women which has a prevalence of 0.17%-5.9% in asymptomatic women and 7.1%-12% in symptomatic women of all ages. Making a differential diagnosis among adnexal masses is difficult and complex. Recognizing the severity of the problem, appropriate and timely evaluation and treatment with good outcome is the goal. Aim: To find out the validity of Ultrasonography (USG) and Magnetic Resonance Imaging (MRI) in evaluation of uterine adnexal masses. Materials and Methods: A cross-sectional study of 50 subjects with suspected various adnexal masses has been conducted over a period of two years from November 2017 to November 2019 in the Department of Radiodiagnosis and Pathology, for USG were included. All patients later underwent surgery and biopsy specimens were sent for Histopathological Examination (HPE). The data was entered in master chart then mean, Standard Deviation (SD) and other statistical tests was applied and analysed using Statistical Package for the Social Sciences (SPSS) 16 statistical package, Chi-square test has been used to compare the sensitivity of Transabdominal Ultrasound (TAUS) and MRI scan with level of significance of <0.05. The results were expressed in form of tables, charts, graphs, figures and photographs. Results: The subjects age ranged from 9 to 84 years with a mean age of 40.36. Ovary was the most common site of origin of adnexal masses was (right 44% and left 30%), main symptoms was lump followed by pain abdomen. Most common adnexal masses on HPE were papillary followed by serious cystadenocarcinoma in malignant cases. USG showed an overall sensitivity of 88.9%, specificity of 81.3% PPV-72.7% and NPV92.9% in comparison to the histopathological findings benign cases had peripheral vascularity (65.62%) and had 59.4% cases with more than 0.8 resistive index. Among malignant cases (88.9%) had central vascularity with 83.3% cases having resistive index less than 0.8. Sensitivity, Specificity, PPV, NPV of MRI was 94.4%, 93.8%, 89.5% & 96.8%, respectively. Conclusion: USG is the initial choice of imaging modality for evaluation of adnexal mass lesions. But imaging with MRI has high accuracy in identifying the origin of a mass, characterizing its tissue content and staging and preoperative plan. But still the HPE of specimen obtained from laparotomy of adnexal mass is the gold standard for confirming the diagnosis.

Keywords

• benign
• histopathological examination
• malignancy
• vascularity