EVALUATION AND CHARACTERIZATION OF OF PELVIC MASSES OF GYNECOLOGICAL ORIGIN BY USG, COLOR DOPPLER AND MRI IN FEMALES OF REPRODUCTIVE AGE GROUP

Namita Bhagat; Ramesh Chander; Arvinder Singh; Sohan Singh; Neelam Gauba; Poonam Ohri

EVALUATION AND CHARACTERIZATION OF OF PELVIC MASSES OF GYNECOLOGICAL ORIGIN BY USG, COLOR DOPPLER AND MRI IN FEMALES OF REPRODUCTIVE AGE GROUP

Namita Bhagat, Ramesh Chander, Arvinder Singh, Sohan Singh, Neelam Gauba, Poonam Ohri

Abstract

Background: Thepelvicmassesmaypresentatanystageoflife.Whileevaluatingapelvicmass, gynecologistshouldconsideranovarianetiologyasitisresponsiblefor70%ofpelvic massesfoundatexploratorysurgery.Aims & Objectives:TheobjectivesofthestudyweretoquantifytheroleofSonography,ColorDopplerand MRIindeterminingtheimagingcharacteristicsofpelvicmassesofgynecologicaloriginin reproductiveage,andtocorrelatethefindingswithsurgical,medicaland histopathological outcome.Material & methods: Thepresentstudywasconductedon100 non-pregnantfemalepatientsofreproductiveagegroupbetween15-45years withclinically diagnosed pelvic mass.Results: The majority of patients 50(50%)were in the age group of 26-30years,(56%)cases presentedwith pain abdomen.22(22%) withmenorrhagia,8(8%)hadalump, and 5(5%)presented withinfertility. The majorityofthepelvicmasses 63% wereofovarian, 20% uterineand17%weretubalinorigin.Thehemorrhagiccystswerethemostcommonpelvicmass(25%)followedbyfibroids (20%),mucinouscystadenomas(18%),hydrosalpinx(10%),pyosalpinx(5%),ovariantorsion(3%), serouscystadenoma,ectopicpregnancyandmucinouscystadenocarcinoma(2%) anddysgerminoma(1%).Conclusions: Inourstudy,weconcludethatthestructuralanalysisof lesionscanbedoneonUSG.ColorDopplersonography(CDS)actsasanadjuncttoUSG,butaswitnessedinourstudy thereisaconsiderableoverlapbetweenRI,PIandPSVofbenignandmalignantmasses.MRIisanexcellenttechniquefordetectionandcharacterizationofadnexalanduterine masses.

Full Text:

PDF

References

REFERENCES

Moore RG, Bast RC, Jr. How do you distinguish a malignant pelvic mass from a benign pelvic mass? Imaging, biomarkers, or none of the above. J ClinOncol.2007; 25:4159-61.

Troiano RN, McCarthy S. Magnetic resonance imaging evaluation of adnexal masses. Seminars in ultrasound, CT and MRI. 1994;15:38-48.

Schwartz LB, Seifer DB. Diagnostic imaging of adnexal masses – a review. The Journal of Reproductive Medicine.1992; 37:63-71.

. Padubidri VG, Daftary SN. Disorders of the ovary. In: Padubidri VG, Daftary SN Eds. Hawkins and Bourne: Shaw’s textbook of Gynaecology. New Delhi: BI Churchill Livingstone Pvt. Ltd; 1999.310-35.

Goff BA, Mandel LS, Drescher CW, Urban N, Gough S, Schurman KM, et al. Development of an ovarian cancer symptom index: possibilities for earlier detection. Cancer. 2007;109:221–7.

Perera DS, Prabhakar HB. Imaging of the Adnexal Mass. Clinical obstetrics and gynecology. 2015;58 (1):28-46.

Jeong YY, OutwaterEK, Kang HK. Imaging evaluation of ovarian masses. Radiographics. 2000;20:1445-70.

. Alpern MB, Sandler MA, Madrazo BL. Sonographic Features of Paraovarian Cysts and their Complications. Am J Roentgen. 1984;143:157-60.

. Khurana I, Satia MN. Preoperative evaluation of ovarian masses with color Doppler and its correlation with pathological finding. Int J Reprod Contracep Obstet Gynecol. 2016;5(7):2084-92.

Wasnik AP, Menias CO, Bhosale PR, Elsayes KM. The Adnexa. In Cross-Sectional Imaging of the Abdomen and Pelvis 2015. New York

Allen BC, Hosseinzadeh K, Qasem SA, Varner A, Leyendecker JR. Practical approach to MRI of female pelvic masses. Am J Roentgenol. 2014;202 (6):1366-75.

Andreotti RF, Harvey SM. Sonographic evaluation of acute pelvic pain. Journal of Ultrasound in Medicine. 2012;31:1713-8.

Potter AW, Chandrasekhar CA. US and CT Evaluation of Acute Pelvic Pain of Gynecologic Origin in Nonpregnant Premenopausal Patients. Radiographics. 2008;28 (6):1645-59.

. Wasnik AP, Menias CO, Platt JF, Lalchandani UR, Bedi DG, Elsayes KM. Multimodality imaging of ovarian cystic lesions: review with an imaging based algorithmic approach. World J Radiol 2013;5:113–25.

Timor‐Tritsch IE, Lerner JP, Monteagudo A, Murphy KE, Heller DS. Transvaginal sonographic markers of tubal inflammatory disease. Ultrasound Obstet Gynecol. 1998;12 (1):56-66.

. Valentini AL, Gui B, Miccò M, Mingote MC, De Gaetano AM, Ninivaggi VA et al. Benign and suspicious ovarian masses—MR imaging criteria for characterization: Pictorial review. Journal of Oncology 2012; Volume 2012, Article ID 481806.

. Moyle PL, Kataoka MY, Nakai A, Takahata A, Reinhold C, Sala E. Nonovarian Cystic Lesions of the Pelvis 1. Radiographics. 2010;30 (4):921-38.

Kirsch JD, Scoutt LM. Imaging of ectopic pregnancy. Applied Radiology. 2010;39 (3):10.

. Kataoka ML, Togashi K, Kobayashi H, Inoue T, Fujii S, Konishi J. Evaluation of ectopic pregnancy by magnetic resonance imaging. Human reproduction. 1999;14 (10):2644-50.

Scully RE. Histological classification of ovarian tumors. In Histological Typing of Ovarian Tumours. Berlin, Heidelberg: Springer; 1999. 3-9.

. Jung SE, Lee JM, Rha SE, Byun JY, Jung JI, Hahn ST. CT and MR Imaging of Ovarian Tumors with Emphasis on Differential Diagnosis. Radiographics. 2002;22 (6):1305-25.

. Fleischer AC. Color Doppler sonography of uterine disorders. Ultrasound Q. 2003;19 (4):179-89.

. Rha SE, Byun JY, Jung SE, Lee SL, Cho SM, Hwang SS et al. CT and MRI of uterine sarcomas and their mimickers. Am J Roentgenol. 2003;181 (5):1369-74.

Shah D, Shah S, Parikh J, Bhatt CJ, Vaishnav K, Bala DV. Doppler ultrasound: a good and reliable predictor of ovarian malignancy. The Journal of Obstetrics and Gynecology of India. 2013;63(3):186-9.

. Buy JN, Ghossain MA, Hugol D, Hassen K, Sciot C, Truc JB, et al.Characterization of adnexal masses: combination of color Doppler and conventional sonography compared with spectral Doppler analysis alone and conventional sonography alone. Am J Roentgenol. 1996;166 (2):385-93.

Abbas AM. The Predictive Value of Transvaginal Color and Pulsed Doppler in Evaluation of Adnexal Masses. Thai J Obstet Gynaecol 2015;23(1).

Madan R, Narula M K, Chitra R, Bajaj P. Sonomorphological and color Doppler flow imaging evaluation of adnexal masses. Indian J Radiol Imaging 2004;14:365-72.

. Stein SM, Laifer-Narin, RomanLynda Differentiation Of benign and malignant adnexal masses with: Relative value of grayscale, color Doppler, and Spectral Doppler sonography. Am J Roentgenol. 1995;164:381-6.

Caruso A, Caforio MD ,Testa AC ,Caiampelli M, Benedetti P. Transvaginal color Doppler sonography in the presurgical characterization of adnexal masses Gynecol Oncology. 1996;63:184-91.

. Sandeep J, Jyothi SM. Ultrasonographic Profile of Patients with ovarian tumors. Global Journal For Research Analysis. 2016;4(9):115-6.

. Kochiyil J, Vernekar J. Utility of MRI in uterine and adnexal lesions. International Journal of Medical Research and Review. 2016;4(04): 655-63.

. Guerriero S, Alcazar JL, Coccia ME, Ajossa S, Scarselli G, Boi M, et al.Complex Pelvic Mass as a Target of Evaluation of Vessel Distribution by Color Doppler Sonography for the Diagnosis of Adnexal Malignancies Results of a Multicenter European Study. J Ultrasound Med. 2002;21:1105-11.

Takeuchi M, Matsuzaki K, Nishitani H. Susceptibility-weighted MRI of endometrioma: preliminary results. Am J Roentgenol 2008;191:1366– 70.

Sue W, Sarah SB. Radiological appearances of uterine fibroids. Indian J Radiol Imaging. 2009;19:222-31.

. Guerriero S, Ajossa S, Garau N, Piras B, Paoletti AM, Melis GB. Ultrasonography and color Doppler-based triage for adnexal masses to provide the most appropriate surgical approach. Am J Obstet Gynecol 2005;192:401–6.

Pereira JM, Sirlin CB, Pinto PS, Casola G. CT and MR imaging of extrahepatic fatty masses of the abdomen and pelvis:techniques, diagnosis, differential diagnosis, and pitfalls. Radiographics 2005;25:69– 85.

Kim MY, Rha SE, Oh SN, Jung SE, Lee YJ, Kim YS, et al. MR Imaging findings of hydrosalpinx: a comprehensive review. Radiographics 2009;29:495–507.

. Buy JN, Ghossain MA, Sciot C, Bazot M, Guinet C, Prevot S, et al.Epithelial tumors of ovary: CT findings and correlation with US. Radiology. 1994;178:811-8.

. Salem FM, Alarabawy RA, El-Ebiary MT, Edorf AA, Abozeid SM. Imaging modalities in the differentiation of various adnexal lesions. Tanta Medical Journal. 2016;44(2):39-52.

Refbacks

There are currently no refbacks.