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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 15, Issue 3, July 2015 pp 643-647
Sonographic evaluation of gynaecological pelvic masses
Alka Patil1, Lavanya Anuranjani2
1Professor and HOD, 2Sr. Resident Department of Obstetrics and Gynecology, ACPM Medical College, Dhule, Maharashtra, INDIA.
Introduction: The legion of pelvic masses confront the Gynaecologists with the dilemmas that pose diagnostic and management challenges in differentiating the various pelvic masses and it has been seen many a times that the final diagnosis after laparotomy is a different one. There is a need to differentiate among various structures and to assess the degree of danger that such a lesion represents to the patient. The understanding about various differential diagnosis is vital. Aims and Objective: To evaluate role of Sonography in the diagnosis of gynaecological pelvic masses and correlating them with final histopathological diagnosis. Materials and Method: The present study was conducted at department of Obstetrics and Gynaecology of ACPM medical college, Dhule during the period of June 2013 to October 2014. Total 100 cases of fulfilling the inclusion criteria were enrolled in the present study. A detailed history of presenting complaints and associated symptoms were noted along with menstrual history. A thorough general and systemic examination was performed. Examination assessed the presence or absence of mass (upon P/A, P/Sp or P/V). Various biochemical investigations were undertaken as per the proforma along with Ultrasonography (Transabdominal/ Transvaginal). After surgical treatment all specimens were submitted for detailed Histopathological examination. The final diagnosis was concluded based on Histopathological Diagnosis. The comparison of various pelvic lumps was done with Histopathological Diagnosis which was taken as Gold Standard. Finally, the clinical diagnosis was analyzed as regards to their true positivity, false positivity and false negativity by correlating them with final histopathological diagnosis. Results: Ultrasonography suggested that there were 46% cases of fibroid, 15% cases of adenomyosis, 12% cases of polyp and 3% cases were having collection in endometrial cavity. 1% was detected as having normal USG findings. Among the adnexal structures; 5% were diagnosed as Hydrosalpinx, 3% chocolate cyst. 11% were diagnosed as ovarian masses and 7% as Tubo- ovarian mass. Histopathological diagnosis was taken as final diagnosis. HPE reports found that the most common mass was fibroid (53%). Other masses were Adenomyosis (11%), Chocolate cyst 3%, Polyp (13%). Out of which endometrial polyps were 9%, cervical were 4%. Pyometra was seen in 3%, Hydrosalpinx in 3%, Benign ovarian tumors were seen in 15% cases, Cancer Cervix in 2%, Malignant ovarian mass in 1% and Endosalpingiosis in 1%. Ultasonographic Sensitivity of diagnosing was quite good for certain uterine and adnexal masses. Diagnostic sensitivity for fibroid was 84.91%, polyp was 92.31%, cervical cancer was 0%, adenomyosis was 90.91%, ovarian mass (benign and malignant) was 62.5% and 100% for Pyometra, Hydrosalpinx and chocolate cyst. However the sensitivity was zero for cancer cervix and Endosalpingiosis. Conclusion: Thus in the end we conclude that ultrasound can be used as an effective tool in diagnosing gynaecological pelvic masses. Ultrasonography can be more useful in detecting non-palpable or suspicious pelvic masses than the palpable pelvic masses.