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

Authors

Yilma, Tesfa

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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 st

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Keywords

Histopathologic diagnosis,adnexal masses,Ultrasonography

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