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

ABSTRACT

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