Gray scale ultrasonography, color doppler and laparoscopy in evaluating pelvic adnexal masses

ABSTRACT

In this study 46 patients with adnexal masses were evaluate. Of clinical, sonographic, Doppler and laparoscopic examinations were compared after correlation with histopathological examination. Clinical examination had the same sensitivity as ultrasound in evaluating malignant lesions. Sensitivity and specificity for diagnosis of malignant ovarian masses were 100%, 71.05% and 66.67%, 84.85% for gray-scale and Doppler respectively. Combination of gray-scale and Doppler improved the diagnostic accuracy to 85%. Laparoscopy had the highest sensitivity [100%] and specificity [97.06%] in evaluation of adenxal masses and in differentiating ovarian from other adenxal lesions. So, it is considered as the best diagnostic modality for diagnosis of doubtful cases of adenxal lesions and differentiating the anatomical origin of such masses. The most characteristic gray-scale sonographic criteria for diagnosis malignant varian tumour were presence of solid component, papillary projections, thick septa and ascites. Neovascularization with peripheral and central blood vessels and low Doppler indices were important Doppler features of malignant lesions. A cut off value of 0.96 for PI and 0.4 for RI gave the most reasonable sensitivity and specificity for discriminatin benign and malignant lesions