Transabdominal Ultrasonographic Evaluation of Adnexal Mass with Histopathological Comparison

Abstract

Background: Transabdominal ultrasonography (TAUS) is a key diagnostic tool in gynecology, providing crucial insights into adnexal masses. These masses, including ovarian tumors and cysts, present a wide range of pathologies from benign to malignant. Accurate characterization is vital for determining appropriate management strategies, with TAUS offering advantages such as non-invasiveness, cost-effectiveness, and real-time imaging. Objective: To evaluate the diagnostic performance of Transabdominal ultrasonography in the diagnosis of adnexal mass. Materials and methods: This cross-sectional analytical study was conducted in the Department of Radiology and Imaging of Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh in collaboration with the respective departments of Gynecology and Obstetrics and Pathology. Total 65 patients were enrolled during the period from January, 2018 to December, 2019 to assess the diagnostic value of transabdominal USG scan in comparison with the histopathological comparison. All the relevant collected data were analyses performed by using the Statistical package for Social Science (SPSS) version 23.0. Results: Mean age of the study subjects was 36.96 years. Majority Study Subjects belonged to age group 25-34 years (32.30%).  Around 69.23% study subjects had abdominal pain and tenderness as clinical feature and 12.30% had abdominal lump. 10.76% study subjects were irregular menstruation and 9.23% had weight loss.  Majority of masses had homogenous echogenicity (63.08%) and mixed echogenicity (36.92%). Majority of masses had thin septations (73.84%), others had thick septations (26.15%). Majority masses had posterior acoustic enhancement (90.65%) and 9.35% masses didn’t have posterior acoustic enhancement.  Majority study subjects were diagnosed as benign ovarian tumour (65%) and (35%) were diagnosed as malignant ovarian tumour according to USG. Majority of study subjects were diagnosed as benign ovarian tumour (69.2%) and 30.8% were diagnosed as malignant ovarian tumour according to Histopathology. USG had 90% sensitivity to correctly diagnose malignant lesions as malignant ones but much lesser specificity (88.89%) to differentiate benign as benign. Overall, the accuracy is 89.23%. Conclusion: The study findings suggest that when compared to the gold standard, transabdominal ultrasonography. Consequently, transabdominal ultrasonography proves to be a valuable imaging method for diagnosing adnexal masses. In resource-rich settings, it could serve as a supplementary diagnostic tool. Further research with larger sample sizes across multiple centers is warranted to enhance result precision.

Journal of Paediatric Surgeons of Bangladesh (2026) Vol. 17 (1): 48-53