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Adnexal masses pose a special diagnostic challenge and suspicion for malignancy is based largely on imaging appearance. As a primary imaging modality, ultrasonography (US) can provide diagnostic information for evaluating ovarian masses. This study had revealed the change of spectral Doppler wave form characteristics (resistive index, pulsatility index) of ovarian masses and differentiates them into benign and malignant lesions and correlate with histopathological findings. Material and Methods: Thirty nine women who were referred to the radiology department for abdomen or pelvis USG from Gynaecology OPD at a tertiary care hospital, Kishanganj, Bihar with a clinical diagnosis of adenexal mass by per abdomen or per vaginal examination or history of irregular lower abdominal pain or bleeding disorder were included in the study. Transabdominal USG with Doppler study was performed in all cases. On spectral Doppler, the lowest resistance index (RI), and maximum peak systolic velocity (PSV) detected at any point in the mass was used for analysis. After USG patients were planned for surgery. Accordingly then post operated excised tumor were send for histopathology. Thus this study was a correlation of USG finding (including grey scale and Doppler) in cases of ovarian/adenexal masses considering with histopathology as a gold standard. Results: Different variables on USG and CDUS were used in diagnosis of benign and malignant ovarian tumors in 39 patients. A total of 56 masses detected in right and left adenexa. Excellent agreement between histopathology and USG (grey scale and CDUS) was found for the diagnosis of benign and malignant tumor of ovary. CDUS shows RI value ranges from 0.4 to 0.9 are malignant and PI value ranges from 0.48 to 1.33 which is comparable with literature. Grey scale USG shows necrosis and calcification present in all malignant cases proved histopathologically. Among 39 patients 13 shows flow within the tumor, but only 4 of them which were proved by histopathology as malignant ranges from 0.4-0.9. however 6 of them shows value ranges from 0.8-0.9 (borderline) but they were proved as benign by histopathology and USG sensitivity found to be 100%, specificity 80%, PPV 36% and NPV 100%. Conclusion: Multiparameter analysis utilizing B-mode USG along with Color Doppler and Spectral Doppler is the mainstay in diagnosis of patients with ovarian tumors.

Evaluation of Ovarian Masses by Color Doppler Imaging and Histopathological Correlation