الفهرس 
AnatomyOnly 14 pages are availabe for public view
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Abstract
The presence of an adnexal mass is one of the leading indications for gynecological surgery. About 0.5% -10% of women will undergo surgery for a suspected adnexal mass. Ovarian tumors are the second most common gynecological tumor.
Although the final diagnosis of an ovarian tumor is based on the histological examination, it is desirable to preoperatively differentiate benign, borderline ovarian tumors and invasive ovarian cancers in order to decide whether surgery is required and which type of surgery is appropriate. Thus, it can help avoiding unnecessary surgery especially in postmenopausal women and help deciding for conservative surgery for young ones wishing to preserve childbearing potential.
The aim of this work was to evaluate the role of different imaging modalities in characterization of adnexal lesions.
This study included 40 female patients aged between (7-65 years) with 50 adnexal lesions. After clinical evaluation, pelvic US examination was done for all cases. After observing all gray scale features, color Doppler was superimposed on the gray images to assess the site of blood flow. MRI was done in 18 suspicious cases. The results were correlated with operative and histopathological findings.
Abdominal and vaginal ultrasound is the first imaging modality that can be used for detection of adnexal mass lesion. About 50 different lesions were found including (hydrosalpinx, ectopic pregnancy, TOA, PCO, solid, cystic and complex lesions). The most frequent lesions were the cystic lesions either septated, vegetated or not.
The introduction of US (abdominal & vaginal) and color Doppler helped in discriminating benign from malignant lesions.
The introduction of color Doppler scanning allowed the assessment of lesion vascularity. Its addition decreases the false positive rate of morphologic evaluation.
Of all the ultrasonographic parameters, thick papillary projections, solid echogenic areas and presence of central vascularization on color Doppler are most consistently associated with malignancy.
Conventional MRI provides soft tissue characterization based on different signal intensities and contrast uptake in post contrast images. It was done for equivocal lesions including (hemorrhagic cysts, endometrioma, dermoid cyst, TOA, hydrosalpinx and dysgerminoma).
We concluded from this study that:
• Ultrasound (abdominal and vaginal) is the primary modality for detection of adnexal masses being available and inexpensive.
• The introduction of color Doppler scanning allowed the assessment of lesion vascularity and helped in assessment of the neoplastic nature of the lesions.
• Using US and color Doppler studies was found to be useful in differentiating a benign from a malignant adnexal mass.
• MR imaging has shown to be beneficial in characterizing and diagnosis confirmation of adnexal masses in problematic cases.