Clinical Study on Findings of Ultrasound and Computed Tomography Scan in the Diagnosis of Ovarian Mass Lesions

ABSTRACT

Background: Ultrasonography (USG) is a simple and noninvasive diagnostic tool that gives lots of data to accurately characterize most of the ovarian mass lesions with a sensitivity and specificity of 88–96% and 90–96%, respectively. However, the presence of significant variability in the terminology and definition of USG findings has led to the need for more standardization and uniformity in adnexal USG. Computed tomography (CT) scan is used primarily in patients with ovarian malignancies, either to assess disease extent before surgery or as a substitute for second-look laparotomy. Moreover, spiral CT has several advantages such as its rapidity and possibility of identifying all potential sites of peritoneal implants or lymphadenopathy as well as of the primary tumor site. Aim of the Study The study was to the clinical findings of both USG and CT scan of abdomen and pelvis in the accurate diagnosis of ovarian mass lesions. Materials and Methods: A total of 104 patients with mass lesions of the ovary were included and subjected to USG and CT scan of abdomen and pelvis. Transabdominal and transvaginal USG studies were undertaken in all the patients. USG findings and CT scan findings were observed recorded and analyzed. Ovarian pathologies were categorized as benign, malignant, and metastasized and the results of CT and USG were compared. Observations and Results: A total of 104 patients with ovarian mass lesions attending the Radiology Department of a Tertiary Teaching Hospital in Kerala were included in the study; patients were aged between 18 and 68 years with a mean age of 42.46 ± 5.70 years. Patients aged between 19 and 58 years accounted for more than 80% of the entire subjects. Hemorrhagic cyst was the most common mass lesion diagnosed in this study and accounted for 28 (26.92%) patients. Tubo-ovarian abscess accounted for 19/104 (18.26%) of the total cases. This was followed by mucinous cystadenoma 17/104 (16.34%), serous cystadenoma in 13/104 (12.50%) cases, polycystic ovarian disease in 11/104 (10.57%), mature cystic teratoma in 7/104 (6.73%), simple cyst in 6 (5.76%), Brenner tumor in 2/104 (1.92%), and endometrioma in 1/104 (0.96%) patients. Conclusions: CT scan and USG are two excellent noninvasive methods to differentiate ovarian mass lesions from benign and malignant lesions and both imaging techniques seemed to be comparable in differentiating malignant from benign ovarian tumors. CT scan was more sensitive than USG, but sonography is more specific than CT scan in diagnosis of malignant lesions. USG has high positive predictive value as compared to CT scan to diagnose malignant lesions.