Role of sonography in the assessment of pelvic masses in women and its histopathological correlation

Abstract

Background: Abnormal growth of tissues in gynecologic pelvic organs like uterus, cervix or uterine adnexa are termed as female pelvic masses. Pelvic masses can be benign or malignant in nature. An efficient non-invasive treatment modality is essential for effective management and efficient treatment of pelvic masses. Current investigation is aimed towards estimating the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of ultrasonography in diagnosing pelvic masses and differentiating benign and malignant pelvic masses.Methods: A descriptive study was conducted on 100 volunteers for 12 months at ultrasound department of radio-diagnosis in a tertiary care center. Patients were examined through transabdominal ultrasonography, covering entire pelvis. Morphology of pelvic lesions were examined in longitudinal and transverse planes through Doppler coupled with ultrasonography. Post-surgery histopathological examination reports were correlated with pre-operative imaging findings.Results: Majority of patients included in current study belonged to <40 years of age group and exhibited benign pelvic masses. Sensitivity and specificity of ultrasound in diagnosing benign masses was observed to be 87.5 and 70 respectively with PPV of 92.1 and NPV of 58.3. Majority of benign lesions were hypoechogenic, whereas malignant lesions were of mixed echogenicity. Most of the malignant lesions showed echogenic focus significantly different from malignant lesions.Conclusions: Ultrasonography was concluded to be primary modality and best screening tool for evaluation of pelvic masses with high sensitivity and specificity for correctly diagnosing and differentiating benign and malignant pelvic lesions. Ultrasonography coupled with color Doppler was efficient in determining the morphological characteristics of pelvic masses.