Ultrasonography and its Correlation with Histopathologic Diagnosis in Adnexal Masses at Tikur Anbessa Specialized Hospital, 2020, Addis Ababa, Ethiopia (A Retrospective Cross Sectional Study)
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Date
2020-11
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Addis Abeba University
Abstract
Background: Adnexal mass is a common gynecologic problem. The role of imaging is
differentiating malignant and benign adnexal masses with intention of guiding patient
management. Ultrasonography is the initial imaging modality used in the evaluation of adnexal
masses and histopathology is the gold standard in confirming the diagnosis.
Objective: Correlation of ultrasound findings with histopathologic diagnosis of adnexal masses
at Tikur Anbessa Specialized Hospital.
Methods: A cross-sectional retrospective study was analyzed from a period of July 1
2016 to
June 30 2020 G.C (4-year period) at Tikur Anbessa Specialized Hospital. Medical records of all
patients operated for adnexal pathologies were retrieved. Ultrasonographic findings and
examiner’s final diagnosis of the mass as to benign or malignant was recorded and its
histopathologic correlation was done using kappa statistical method.
Result: In this study, of 75 patients with adnexal masses, 41 were malignant and 36 were
correctly predicted with ultrasonography. The sensitivity, specificity and accuracy of ult rasound
in diagnosing adnexal masses were 87.5%, 70.6% and 80% respectively. We found a positive
predictive value (PPV) of 78.3% and a negative predictive value (NPV) of 82.8%. Moderate
level of agreement was found between ultrasonography and histopathologic diagnosis with kappa
value 0.59.
Conclusion and recommendation: USG showed excellent sensitivity with reduced specificity
in diagnosing malignant adnexal masses. The lower specificity of USG in predicting benign or
malignant adnexal pathologies could lead to unnecessary surgical intervention. However, its
inherent advantage of wide availability, inexpensive, lack of radiation and acceptable sensitivity
in diagnosing benign and malignant adnexal masses make an USG an important tool in guiding
further patient management. Establishing standardized reporting protocol using ovarian-adnexal
reporting lexicon for USG and further multicenter prospective studies with strict application of
IOTA simple rules for benign and malignant adnexal masses with different level of operator
experience are recommended to make good use of USG in optimizing patient treatment in our
setting
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Keywords
Histopathologic diagnosis,adnexal masses,Ultrasonography