[Ultrasonographic clarification of adnexal findings]

The most important diagnostic test for clarification of an adnexal mass is ultrasonographic evaluation. The prognostic value of an ultrasonographic examination is higher in combination with the patient history and clinical findings. In order to achieve high diagnostic accuracy certain requirements are mandatory. Firstly a high level of expertise, meticulousness and patience of the examiner is crucial. Secondly the use of a high-end ultrasound machine is essential. Thirdly a thorough evaluation and interpretation of sonomorphologic findings are necessary. Furthermore, these skills have to be trained continuously. This is fundamental for subjective, sonographic pattern recognition and the successful use of tumor scores resulting in a correct classification of adnexal tumors. Most adnexal tumors (approximately 75%) can be correctly (sensitivity 95% and specificity 91%) classified as benign or malignant using a set of simple rules. Tumors which cannot be classified (approximately 25%) can be differentiated by ultrasound examination by an expert examiner on the basis of subjective evaluation in about 90% of cases.