RADIOLOGICAL AND IMAGING DIAGNOSIS OF ADNEXAL MASSES

Abstract

Adnexa uterii, comprising the ovaries, tubes & broad ligaments are the site of origin of various neoplastic & non­ neoplastic lesions that represent a challenge for diagnostic Imagmg. The most frequently encountered adnexal masses include functional ovanan cysts, tubal inflammatory lesions, endometriosis, ectopic pregnancy, dermoid cyst & various ovarian malignancies. Plain radiography, as a basic radiographic maneuver is alone incapable of accurate delineation of an adnexal mass & consequently cannot determine its nature. It only shows incidental calcifications or bowel displacement raising the suspicion about the presence of an abnormality. Hysterosalpingography, though invasive & requiring exposure to ionizing radiation, is still the most accurate imaging technique in diagnosing various tubal lesions & accurately determining the sites of pelvic adhesions. Sonohysterosalpingography is now a new era that proved promising results in assessment of tubal patency, but is still far inferior to traditional hysterosalpingography regarding diagnosis of other variants of tubal lesions. Abdominal ultrasonography is an important non-invasive screening method for female pelvic lesions that utilizes non ionizing radiation & is of low fmancial cost. It can detect a wide spectrum of pathology & is capable of characterizing some adnexal masses, determining their abdominal extension. It is the basis of further diagnostic evaluation of a detected adnexal lesion