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Sonographic evaluation of gynecological masses with its pathological correlation

International Journal of Radiology & Radiation Therapy
Rajiv Ranjan Kumar,1 Pankaj Sharma,2 Prashant Gupta1  

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Introduction:The differentiation of adnexal masses as benign and malignant is difficult on imaging and first modality used for this purpose is Ultrasound.
Aim:To assess the usefulness of Gray Scale Ultrasound and Colour Doppler in differentiating benign and malignant adnexal masses in Indian population, by using a scoring system proposed by Alcazar, et al.
Materials and methods:The study was conducted in Department of Radiodiagnosis, Deen Dayal Upadhyay Hospital and Delhi over a one year period. Fifty patients were evaluated using scoring system proposed by Alcazar JL, et al. The efficacy of scoring system was evaluated by fine needle aspiration cytology or histopathological examination of the mass as a gold standard. Statistical analysis was done using the SPSS Stastical Package. Data was analyzed statistically by one way ANOVA and the Student t test for independent samples. The chi square test was used for categorical data. A probability value less than 0.05 was considered statistically significant.
Results:In present study, most significant parameters came out to be thick papillary projection i.e> 3mm (p=0.01) and thick septa i.e> 3mm (p=0.02) on grey scale and resistive index<0.4 (p=0.006), high velocity/low resistance flow (p=0.01) and moderate to abundant flow (p=0.01) on Colour Doppler.
Conclusion:Present study serves to emphasize the role of Ultrasound gray scale and Colour Doppler to differentiate benign from malignant adnexal mass and usefulness of Alcazar scoring system. Important parameters in this study, which helped in differentiating benign and malignant adnexal masses, were: thick papillary projection, thick septa and resistive index<0.4, high velocity/low resistance flow and moderate to abundant flow.


ultrasonography, doppler, velocimetry, transvaginal, echotexture