A Hospital-Based USG Assessment of Gynecological Masses with its Pathological Correlation: An Observational Study

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Abstract (English)

Abstract
Aim: The aim of this study was to assess the usefulness of Gray Scale Ultrasound and Colour Doppler in
differentiating benign and malignant adnexal masses in the population.
Methods: The study was conducted in Department of Obstetrics and Gynecology, Nalanda Medical College and
Hospital, Patna, Bihar, India over a one year period. This study was done as part of dissertation for post graduate
qualification in Obs and Gyne.
Results: The mean age of patients with benign tumor and malignant tumor was 32.64±8.2 years and 50.25±12.8
years respectively. Mean volume of malignant adnexal masses (932.38±648.32) was significantly higher than
benign adnexal masses (280.80±210.12). Score of 0 or 2 was given depending on absence or presence of thick
papillary projection. Score of 0 or 4 was given depending on absence or presence of solid areas. Score of 0 or 4
was given depending on blood flow location. If no flow or peripheral flow was present, then 0 score was given.
However, if central flow was present, then score of 4 was given. Using this scoring system in our study and
taking cut off value for malignancy > 6, we found that out of total 50 patients, 35 (70%) had score between 0-5
and all of them were found to be benign on FNAC/histopathology. 15 (30%) cases had a score between 6-12,
out of which 12 (80%) were malignant. Only 3 (20%) cases with score between 6-12 were benign.
Conclusion: The Present study serves to emphasized 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