title: Utilization of ultrasound as a diagnostic tool in the preoperative assessment of patients with adnexal masses.
abstract: OBJECTIVE
  To evaluate the reliability of ultrasound scan (US) findings in the preoperative assessment of the nature of adnexal masses in females.
  
  
  METHODS
  After detailed history, a preoperative US examination was performed in all women. Tumor diameter, localization, the presence of solid, cystic and multilocular components, excrescences, metastasis and free fluid were assessed. Doppler scan was done and pulsatility (PI) and resistance indices (RI) were determined. These data were compared with postoperatively obtained histopathological findings and statistically analyzed.
  
  
  RESULTS
  The study included 609 women out of which 20.7% had malignant, 73.7% benign, and 5.6% border-line tumors. Patients with malignant tumors were oldest (p<0.001). There were significantly more positive US parameters in malignant than in benign tumors (p<0.001). Also, there were significant differences (p<0.001) between malignant, benign and borderline tumors regarding all examined US and Doppler parameters except tumor multilocularity. RI had sensitivity 75%, specificity 61.2%, positive predictive value (PPV) 42.70% and negative predictive value (NPV) 96.16%. PI had sensitivity 50%, specificity 35.3%, PPV 8.37% and NPV 25.93%. Sensitivity of US characteristics was 94.34%, specificity 30.62%, PPV 22.27% and NPV 96.25%.
  
  
  CONCLUSIONS
  US pattern characteristics and Doppler parameters were found to be moderately reliable in discriminating malignant, benign and borderline adnexal tumors. Tumor of solid or mixed consistency, presence of ascites and excrescences were the best predictors of malignancy.
authors.affiliation: Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Milan
authors.initials: M
authors.lastname: Terzic
authors.forename: Jelena
authors.initials: J
authors.lastname: Dotlic
authors.forename: Jovan
authors.initials: J
authors.lastname: Bila
authors.forename: Igor
authors.initials: I
authors.lastname: Pilic
authors.forename: Branka
authors.initials: B
authors.lastname: Nikolic
authors.forename: Dusica
authors.initials: D
authors.lastname: Kocijancic
authors.forename: Ivana
authors.initials: I
authors.lastname: Likic
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Arsenovic
authors.forename: Tihomir
authors.initials: T
authors.lastname: Mihailovic
authors.forename: Diana
authors.initials: D
authors.lastname: Bugarski
mesh_terms: D000328:Adult; D019540:Area Under Curve; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D018294:Neoplasms, Adnexal and Skin Appendage / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012372:ROC Curve; D015203:Reproducibility of Results; D016896:Treatment Outcome; D047368:Tumor Burden; D018608:Ultrasonography, Doppler