Validity of ultrasound in detecting benign and malignant ovarian cysts


ABSTRACTBackground: Ovarian tumors are the second most common gynecological malignancy and the fourth most common cancer death in women, which is characterized by few or late symptoms, often called the silent killer. Early detection of ovarian carcinoma could be a formidable challenge and an elusive task.Objectives: To Study sonographic features of benign and malignant ovarian cysts, to find the incidence of benign and malignant ovarian tumours and to determine the accuracy of ultrasound in differentiating benign from malignant ovarian cysts comparing with histopathology results. Patients and methods: This was a cross sectional study. Convenient sample taken from a population consists of 65 women in reproductive age, scheduled for surgery because of ovarian cysts. They underwent preoperative ultrasound examination, done in the Radiology Department of Maternity and Rizgari Teaching Hospitals, Erbil city, North of Iraq. The mean patient age was 30.25 years ranging from 14-46 years.Results: Out of 65 cases, 60 (92.3%) were benign, and 5 cases (7.7%) were malignant. Using sonographic morphological scoring, scores equal or more than 3 was regarded as malignant (the scoring system included wall thickness, shadowing, septa and echogenicity). The accuracy, sensitivity and specificity of ultrasound were 91%, 100% and 90% respectively.Conclusion: Gray scale and Doppler ultrasound yield high diagnostic accuracy in discrimination between benign and malignant cysts. Benign cysts are more common than malignant cysts in female at reproductive age. Mature cystic teratoma (dermoid) is the commonest type of ovarian tumors. Cysts more than 10 cm in maximum diameter, multilocular cysts are more likely to be malignant. The presence of ascites also favors malignancy.Keywords: Ovarian cyst, Doppler ultrasound, pelvic mass.