Clinical impression and ultrasound features in the preoperative evaluation of ovarian masses

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Date
2001-11
Authors
Cheong, Yee Tsing
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Universiti Sains Malaysia
Abstract
Objective : To evaluate the ability of clinical impression and ultrasound features to discriminate a benign from a malignant ovarian mass. Design : A prospective study. Setting Department of Gynaecology, Hospital Tengku Ampuan Afzan, Kuantan, Pahang. Subjects : 126 women admitted consecutively to the gynaecology department for surgical exploration of an ovarian mass between 1st February 1999 and 31st January 2000. Main outcome measures : The sensitivities, specificities, positive and negative predictive values of ultrasound features and clinical impression for discriminating a benign from a malignant ovarian mass. Results : 120 constituted the study population after excluding 6 cases of non-ovarian pelvic pathology. 97 cases ( 81 o/o ) were diagnosed as benign ovarian tumours and 23 cases ( 19°/o ) as malignant. Clinical impression gave the highest level of sensitivity and specificity, followed by ultrasound score of 2-5 in the discrimination between benign and malignant ovarian masses. Both achieved sensitivity and specificity of greater than 70o/o and showed superiority over the individual ultrasound features suggestive of malignancy. Conclusions : Clinical examination and ultrasound scanning are methods which can be applied easily in our centre in the preoperative evaluation of ovarian masses. The diagnostic accuracy may be improved by including tumour markers or more detailed ultrasound assessment, this would be at the expense of simplicity and increased financial cost.
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Ovarian masses
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