REAL TIME ULTRASONOGRAPHIC EVALUATION OF GYNECOLOGICAL PELVIC MASSES - A PROSPECTIVE STUDY

The space occupying lesions in female pelvis are very common over a wide age range. Many pathological conditions give rise to pelvic mass. It is difficult to arrive at an accurate diagnosis on clinical examination alone. Transabdominal and transvaginal ultrasonography are precisely helpful to determine the origin of a mass from uterus, ovaries, adnexal or extra genital structures. Serial sonographic examinations help in assessment of change in size and consistency for monitoring and for evaluation of therapeutic response. Aims: Sonographic evaluation of gynecological pelvic masses to determine the organ of origin, and correlation of sonographic diagnosis with histopathological examination. Method: A hospital based prospective study was done on 50 female patients with gynecological masses using high resolution ultrasonography and findings were correlated with histopathology examination. Result: Sonography was performed in 50 patients after a detailed clinical examination and various diagnoses were made. Patients were followed up to surgical management or serial sonographic monitoring in case of functional lesions. 52% patients were having uterine pathologies like leiomyoma, leiomyoma with pregnancy, adenomyosis, uterine and cervical malignancies, while 46% were having adnexal pathologies like benign ovarian cyst, malignant ovarian cyst, tubo-ovarian mass, cystic teratoma etc. and rest 2% were have other pathologies like localized pus collection in the pelvic cavity etc. Accuracy to identify organ of origin was 100% in the presenting study. In the identification of the uterine pathology, 91% of fibroid diagnosed correctly by ultrasonography while uterine and cervical malignancies were diagnosed with 100% accuracy in the presenting study. In various ovarian pathologies, benign cystic ovarian lesions were detected with 100% accuracy while malignant ovarian masses and tubo-ovarian masses were diagnosed with accuracy of 80% and 85% respectively. Conclusion: Ultrasonography is highly accurate in determining the organ of origin of gynecological pelvic mass. Sonographic