Details
Category: Volume 07 Issue 04 April 2019
Hits: 1535

Title: Role of ultrasonography to evaluate ovarian masses and its correlation with histopathological findings

Authors: Dr Subrat Prasad, Dr. Ichchhit Bharat, Dr Mihir Kumar Jha, Dr Chandni Sehgal, Dr. Dhruba K Uprety, Dr R K Rauniyar

 DOI: https://dx.doi.org/10.18535/jmscr/v7i4.47

Abstract

Background: Adnexal masses present a special diagnostic challenge, in part because benign adnexal masses greatly outnumber malignant ones. As a primary imaging modality, ultrasonography (US) can provide diagnostic information for evaluating ovarian masses. This study was to see the morphological characteristics of ovarian masses by USG and correlate with histopathological findings.

Materials & Methods: Thirty nine women who were referred to the radiology department for abdomen or pelvis USG from Gynecology OPD with a clinical diagnosis of adenexal mass by per abdomen or per vaginal examination or history of irregular lower abdominal pain or bleeding disorder were included in the study.  Transabdominal USG was performed in all cases. After USG patients were planned for surgery. Accordingly then post operated excised tumor were send for histopathology. Thus this study was a correlation of USG finding (including grey scale) in cases of ovarian/adenexal masses considering with histopathology as a gold standard. The age of the patient ranged from 18 to 70, all of them were married.

Results: The predominant symptom was lower abdominal mass, pain and bleeding disorders. Among 39 women only 9 women had Hb% between 8-9 gm%. A different variable on USG was used in diagnosis of benign and malignant ovarian tumors in 39 patients. A total of 56 masses were detected in right and left adenexa. Among them 4 (7.14%) are malignant and 24 masses were benign and rest 28 (50%) were physiological cyst/infective process, which showed only cyst increase in size on follow up USG and these masses were not operated and managed conservatively, hence not included in our analysis. Excellent agreement between histopathology and USG (grey scale) was found for the diagnosis of benign and malignant tumor of ovary. Grey scale USG shows necrosis and calcification present in all malignant cases proved histopathologically. Kappa test shows – agreement between radiology and histopathology finding is 100%.

Conclusion: Sonographically the grey scale is a sensitive modality in detection of malignant changes in ovarian masses.

Keywords: Ovarian mass, Ultrasonography, Grey scale, Histopathology, Benign, Malignant.

References

  1. Timmerman D, Schwarzler P, Collins WP, Claerhout F, Coenen M, Amant F, et al. Subjective assessment of adnexal masses with the use of ultrasonography: an analysis of inter-observer variability and experience. Ultrasound Obstet Gynecol 1999;13:11-16.
  2. Valentin L. Prospective cross-validation of Doppler ultrasound examination and gray-scale ultrasound imaging for discrimination of benign and malignant pelvic masses. Ultrasound Obstet Gynecol 1999; 14:273-283.
  3. Valentin L. Pattern recognition of pelvic masses by gray-scale ultrasound imaging: the contribution of Doppler ultrasound. Ultrasound Obstet Gynecol 1999; 14:338-347.
  4. Sassone AM, Timor-Tritsch IE, Artner A, et al. Transvaginal sonographic characterization of ovarian disease: Evaluation of a new scoring system to predict malignancy. Obstet Gynecol 1991; 78:70.
  5. Lerner JP, Timor-Tritsch IE, Federman A, et al. Transvaginal ultrasonographic characterization of ovarian masses with an improved, weighted score. Am J Obstet Gynecol 1994; 170: 81.
  6. Ferrazzi E, Zanetta G, Dordoni D et al: Transvaginal ultrasonographic characterization of ovarian masses: A comparison of five is scoring systems in a multicenter trial. Ultrasound Obstet Gynecol 1997; 10: 192
  7. Osmers R, Osmers M, von Maydell B et al: Preoperative evaluation of ovarian tumors in the premenopause by transvaginosonography. Am J Obstet Gynecol 1996; 175: 428.
  8. Debnath J, Satija L, Suri A, et al. Follicular monitoring: comparison of transabdominal and transvaginal sonography. Med J Armed Forces India. 2017; 56(1):3–6.
  9. Nazário AC, Nicolau SM, Nishimura CM. Comparison between pelvic endovaginal and transabdominal sonography in the measurement of the uterus and ovaries. Rev Paul Med. 1991 Mar-Apr; 109(2):51-4.
  1. Sayasneh A, Ekechi C, Ferrara L, et al. The characteristic ultrasound features of specific types of ovarian pathology (review). Int J Oncol. 2014;46(2):445–458.
  2. Phillips JF, Goodwin OW. Thomason SB, et al. The volume of the uterus in normal and abnormal pregnancy. J Clin Ultrasound 1977; 5:107.
  3. Wasnik AP, Menias CO, Platt JF, Lalchandani UR, Bedi DG, Elsayes KM. Multimodality imaging of ovarian cystic lesions: Review with an imaging based algorithmic approach. World J Radiol. 2013;5(3):113–125.
  4. Jung SI. Ultrasonography of ovarian masses using a pattern recognition approach. Ultrasonography. 2015;34(3):173–182.
  5. Moorthy RS. Transvaginal sonography. Med J Armed Forces India. 2017;56(3):181–183.
  6. Ekici E, Soysal M, Kara S, Dogan M, Gokmen O. The efficiency of ultrasonography in the diagnosis of dermoid cysts. Zentralbl Gynakol.1996;118(3):136-41.
  7. Sheth S, Fishman EK, Buck JL, Hamper UM, Sanders RC. The variable sonographic appearances of ovarian teratomas: correlation with CT. AJR. 1988;151(2):331-4.
  8. Athey PA, Malone RS. Sonography of ovarian fibromas/thecomas. J Ultrasound Med.1987 Aug;6(8):431-6.
  9. Fishman DA1, Cohen L, Blank SV, Shulman L, Singh D, Bozorgi K. The role of ultrasound evaluation in the detection of early-stage epithelial ovarian cancer. Am J Obstet Gynecol. 2005 Apr;192(4):1214-21; discussion 1221-2.

Corresponding Author

Dr. Ichchhit Bharat

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.