What are the most discriminating two-dimensional and doppler sonographic features in differentiation of benign and malignant adnexal masses?

To determine the two-dimensional and doppler sonographic features that best allow differentiation between malignant and benign adnexal masses, besides develop a new scoring system enable more accurate diagnosis with these features. A cross sectional prospective study was conducted on patients scheduled for surgery due to presence of adnexal masses at Women's Health Hospital, Assiut, Egypt between October 2012 and October 2013. All patients were evaluated by 2D ultrasound for morphological features of the masses aided by doppler examination of their vessels. The final diagnosis was based on histopathological reports used as gold standard. One hundred forty-six patients were recruited, 104 with benign masses, 42 with malignant masses. Features that allowed statistically significant discrimination of benignity from malignancy were; volume of mass, type of mass, presence and thickness of septae, presence and length of papillary projections, location of vessels at colour Doppler and colour score. A scoring formula was supposed combined those features together to develop a new scoring system; Assiut Scoring System [ASS]. The cut-off score with the highest accuracy in detection of malignancy had a sensitivity of 93.5% and specificity of '92.2%. Assiut Scoring System; a multiparameter scoring that use four 2D ultrasound and two doppler features, has a high sensitivity and specificity for prediction of malignancy in adnexal masses

Evaluation of laparoscopic thermocoagulation of polycystic ovaries

Thirty-five infertile patients with PCO had undergone laparoscopic thermocoagulation and were followed for ovulation and pregnancy outcome for six months. Second look laparoscopy was done for nineteen cases. There was significant improvement of amenorrhea and oligohypomenorrhea. 50% of cases ovulated spontaneously and 33% after stimulation. Pregnancy rate was 29%. Minimal-moderate lysable pelvic adhesions occurred in two cases. It was concluded that laparoscopic thermocoagulation of PCO seems to be a promising method of management

Ultrasound measurement of fetal foot length, fetal kidney length and distal femoral epiphyseal diameter as predictors of gestational age

Obstetric ultrasound examinations were carried out on 458 pregnant women between 20 and 40 weeks of gestation. Examinations involved measurement of fetal foot length [FFL], fetal kidney length [FKL] and distal femoral epiphyseal diameter [DFE], in addition to determination of fetal sex. The study provided standard growth tables for each of the three parameters during the second half of pregnancy. Comparison between male and female fetuses has shown constantly longer FFL in male which was occasionally significant, similar FKL in both sexes and slightly bigger DFE in female fetuses than in males. In conclusion, the three parameters could be of additional helpful value in estimating gestational age and fetal maturity. Sex differences may have some influence which should be considered during plotting the growth curves, but this would require further studies

Menstrual dates: sonographic re-appraisal of its value in gestational age determination

In this study, 585 pregnant women with gestational age less than 26 weeks were evaluated both clinically and sonographically for the accuracy of their menstrual dates in Assiut University Hospitals [1990-1991]. Forty one percent of women were not aware of their dates. Dates unreliability were most common in women with high parity [5 or more] and in women presenting in the second trimester of pregnancy. In 25 percent of women who were not sure of their dates, there was no reason for dates unreliability. When women with apparently sure menstrual dates [59 percent] were evaluated with ultrasound, it appeared that 19.4 percent of this group had also inaccurate dates, and this finding was not significantly related to parity or trimester of pregnancy. These findings suggest that menstrual dates in regularly menstruating women are of limited value in gestational age determination even when apparently sure. Sonographic estimations of gestational age seems of basic value in obstetric decisions