CORRELATION BETWEEN SONOGRAPHY AND HISTOPATHOLOGY /FOLLOW UP RESCANS IN THE DIAGNOSES OF ADNEXAL MASSES IN A NIGERIAN POPULATION
Creators: name: Okpaleke M.S
Publisher: name: Zenodo
Year: 2010
Subjects: correlation. sonography, histopathology, diagnoses, adenexal masses

description: Ultrasonography is the study of choice in the initial evaluation of suspected adnexal masses. The grey scale sonographic appearances of some adnexal masses overlap and may lead to erroneous diagnoses thereby limiting its diagnostic accuracy. This raises the query of the accuracy of grey scale sonography in providing precise diagnoses for adnexal masses. In addition, the sonography reports issued in most diagnostic centres in Nigeria are not routinely followed up by the sonographer/sonologist to confirm their diagnostic accuracy. The main objective of the study is to match definitive sonography diagnoses with histopathology diagnoses and serial rescans in order to evaluate the accuracy of sonography as a diagnostic tool for adnexal masses. The secondary objective is to characterize the commonly occurring adnexal masses in the study population. Features identified will serve as a useful guide to sonographers and sonologists for characterizing adnexal masses in Nigeria. In this prospective study, commonly occurring adnexal masses in the population were characterized sonographically in 392 subjects aged between 5 years and 65 years from referrals to the Radiology department of Eko Hospitals, in Lagos State, using standard techniques. Each subject was followed up with the referring gynaecologist/physician to document the management procedure that was embarked upon by the clinical team. One hundred and seventy two (44%) subjects had laparotomy, excision of the mass, and histopathological diagnoses of their masses and 220 subjects who did not require surgery were followed up with serial rescans. Out of the 172 subjects that went for laparotomy,136 (79%) had histopathology diagnoses that matched with initial sonography diagnoses (r = 0.93). Out of the 220 subjects that underwent follow up rescans, 212(96%) had rescan diagnoses that matched initial sonography diagnoses ( r = 0.99) . Three hundred and fourty eight (89%) out of the 392 subjects that underwent laparotomy / follow up rescans had histopathology / follow up rescan diagnoses that matched initial sonography diagnoses {r = 0.99, accuracy (92%), sensitivity (88%), specificity (92%), PPV (49%) and NPV (99%)} while initial sonography diagnoses were erroneous in 44(11%) subjects. A regression model for predicting the accuracy of sonography diagnoses is given by Y = 0.941x – 2.340 (r2 = 0.983, p &lt; 0.05). There was no statistically significant difference between sonography and histopathology diagnoses / follow up rescans noted (χ2 = 3.56, χ20.05 = 5.991, p &gt; 0.05). Benign adnexal masses were common in the study population as they constituted 92% of all identified adnexal masses and were predominantly among premenopausal subjects between 35 and 44 years. They include functional cysts (44%), benign ovarian masses (21%), hydrosalpinx, pyosalpinx and tubo-ovarian abcesses resulting from pelvic inflammatory diseases (10%). The study concludes that grey scale sonography is valuable in the diagnoses of adnexal masses.