Background: Adnexal masses present a special diagnostic challenge, in part because benign adnexal masses greatly outnumber malignant ones. As a primary imaging modality, ultrasonography (US) can provide diagnostic information for evaluating ovarian masses. This study was to see the morphological characteristics of ovarian masses by USG and correlate with histopathological findings.

Materials & Methods: Thirty nine women who were referred to the radiology department for abdomen or pelvis USG from Gynecology OPD with a clinical diagnosis of adenexal mass by per abdomen or per vaginal examination or history of irregular lower abdominal pain or bleeding disorder were included in the study.  Transabdominal USG was performed in all cases. After USG patients were planned for surgery. Accordingly then post operated excised tumor were send for histopathology. Thus this study was a correlation of USG finding (including grey scale) in cases of ovarian/adenexal masses considering with histopathology as a gold standard. The age of the patient ranged from 18 to 70, all of them were married.

Results: The predominant symptom was lower abdominal mass, pain and bleeding disorders. Among 39 women only 9 women had Hb% between 8-9 gm%. A different variable on USG was used in diagnosis of benign and malignant ovarian tumors in 39 patients. A total of 56 masses were detected in right and left adenexa. Among them 4 (7.14%) are malignant and 24 masses were benign and rest 28 (50%) were physiological cyst/infective process, which showed only cyst increase in size on follow up USG and these masses were not operated and managed conservatively, hence not included in our analysis. Excellent agreement between histopathology and USG (grey scale) was found for the diagnosis of benign and malignant tumor of ovary. Grey scale USG shows necrosis and calcification present in all malignant cases proved histopathologically. Kappa test shows – agreement between radiology and histopathology finding is 100%.

Conclusion: Sonographically the grey scale is a sensitive modality in detection of malignant changes in ovarian masses.

Keywords: Ovarian mass, Ultrasonography, Grey scale, Histopathology, Benign, Malignant.

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Dr. Ichchhit Bharat

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