Indian Journal of Radiology Indian Journal of Radiology  

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Year : 2004  |  Volume : 14  |  Issue : 4  |  Page : 365-372
Sonomorphological and color doppler flow imaging evaluation of adnexal masses

Department of Radiology, Lady Hardinge Medical College & Associated Smt. Sucheta Kriplani Hospital, New Delhi 110001, India

Correspondence Address:
M K Narula
J-13/42, Rajouri Garden, New Delhi-110027
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Source of Support: None, Conflict of Interest: None

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Objective: Evaluation of adnexal masses with conventional gray scale and Color Doppler flow imaging to assess the diagnostic reliability of sonographic and Doppler findings to differentiate malignant and benign ovarian masses. Materials and Methods: Sonomorphologic indexing of 74 adnexal masses in 52 patients was done to designate a mass as benign or malignant .The findings of color flow imaging and spectral Doppler were further added to differentiate malignant from benign lesions. The results were correlated with surgery/laparoscopy/FNAC/ follow up scans. Results: Sonomorphology has the highest sensitivity (92.5 percent) and negative predictive value (92.8 percent). Evaluation of vessel morphology and arrangement has the highest specificity (96.8 percent) with a positive predictive value of 95.2 percent. Peak systolic velocity is a better discriminator of malignant versus benign adnexal masses showing lesser degree of overlap as compared to resistive and pulsatility indices. Combined sonomorphologic and vascular scoring increased both the positive predictive value (54.36 percent to 76.6 percent) and diagnostic accuracy (68.9 percent to 80.4 percent) in predicting malignancy. Conclusion: There is considerable overlap in the morphologic patternsof various adnexal masses and hence a multiparameter analysis incorporating morphologic scoring, vessel location, vessel arrangement and spectral waveform analysis is helpful in determining those patients in whom early intervention is necessary.

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