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Three-dimensional sonographic morphologic assessment in complex adnexal masses: preliminary experience.
Juan Luis Alcázar1, María José Galán, Manuel García-Manero
1Department of Obstetrics and Gynecology, Clínica Universitaria de Navarra, School of Medicine, University of Navarra, Pamplona, Spain.
Summary
Three-dimensional transvaginal sonography (3D TVS) showed improved accuracy in diagnosing complex adnexal masses compared to two-dimensional transvaginal sonography (2D TVS). While not statistically significant, 3D TVS aided in confirming initial diagnoses.
Area of Science:
- Gynecologic Imaging
- Diagnostic Ultrasound
- Oncology
Background:
- Complex adnexal masses require accurate diagnostic assessment to differentiate between benign and malignant conditions.
- Two-dimensional transvaginal sonography (2D TVS) is a standard imaging modality, but its limitations in characterizing complex masses exist.
- Three-dimensional transvaginal sonography (3D TVS) offers potential for enhanced visualization and characterization of pelvic structures.
Purpose of the Study:
- To evaluate the diagnostic performance of 3D TVS in assessing complex adnexal masses.
- To compare the accuracy of 3D TVS with 2D TVS in identifying malignant features.
- To determine the role of 3D TVS in improving the morphologic assessment of adnexal lesions.
Main Methods:
- A prospective study involving 41 women with complex adnexal masses diagnosed via 2D TVS.
- Reevaluation of masses using 3D TVS by two experienced sonologists.
- Histopathologic diagnosis obtained after surgical removal for definitive assessment.
Main Results:
- 3D TVS demonstrated higher sensitivity (100% vs. 90%), specificity (78% vs. 61%), and accuracy (89% vs. 75%) compared to 2D TVS.
- Malignant features evaluated included papillary projections, solid areas, and solid echogenicity.
- Despite improved metrics, statistical significance was not reached (P = .687), though 3D TVS reinforced diagnostic impressions.
Conclusions:
- 3D TVS does not significantly enhance the morphologic assessment of complex adnexal masses over 2D TVS.
- However, 3D TVS proved valuable in reinforcing the initial diagnostic impressions made by sonologists.
- The study highlights the complementary role of 3D TVS in the evaluation of complex adnexal pathology.