Diagnosis of Adnexal Masses –Using Ultrasound and Magnetic Resonance Imaging for Proper Management

Abstract

Introduction: Adnexal masses are considered one of the most common disorders in gynecology practice. Primary goal of imaging in the evaluation of an adnexal mass is to differentiate malignant and benign lesions in order to direct patients to the appropriate treatment algorithm. Magnetic resonance imaging (MRI) helps to delineate normal
anatomical structures and elucidate the pathological lesions. It has high sensitivity and specificity for differentiating benign pelvic masses from malignant ones Aim: To assess the relative role of ultrasound (USG) and MRI in the evaluation of adnexal mass lesions and compare them with clinical outcome or operative findings. Materials and methods: Prospective evaluation of 50 patients suspected to have adnexal masses was subjected to ultrasonography followed by MRI and the results were noted. Results: Most commonly affected age group was 21-40yrs. The major presenting complaints were lower abdominal pain and lump in the lower abdomen. In our study, most common origin of adnexal lesions was from ovaries. On USG, 50 % were cystic in consistency, 86 % and 14 % were reported as benign and malignant respectively. On MRI, 56 % were cystic, 88% and 12 % were reported as benign and malignant respectively. Conclusion: USG is recommended as a primary modality for diagnosing pelvic adnexal masses. MRI is superior to ultrasound and can be used in the assessment of problematic cases. The multiplanar imaging capability allows accurate identification of origin and characterisation of adnexal masses.