Diagnostic accuracy of ultrasonography with laparoscopy for assessment of benign adnexal masses


  • Vinita Sarbhai Department of Obstetrics and Gynecology, Kasturba Hospital, Delhi University, Delhi, India
  • Medha Yadav Department of Obstetrics and Gynecology, Kasturba Hospital, Delhi University, Delhi, India




Benign adnexal mass, Laparoscopy, Ovarian cyst, Ultrasound


Background: Adnexal masses are one of the most common pathologies among women of all age groups. Objective of this study was to assess efficacy of ultrasonography in diagnosing adnexal pathology, rule out malignancy and its comparison with laparoscopy and pathology results.

Methods: A total 32 women with benign adnexal mass were evaluated by clinical examination, ultrasonography and laparoscopy. Findings of ultrasound were compared with laparoscopy and histopathology reports and diagnostic accuracy was calculated.

Results: Sensitivity of USG in diagnosing simple ovarian cyst is 20% and specificity is 88.9% while laparoscopy has sensitivity of 100% and specificity of 94.4%. USG versus laparoscopy has sensitivity of 50% versus 100% and specificity of 94.1% versus 100% in diagnosing endometrioma. Sensitivity of USG in diagnosing dermoid cyst is 66.7% and specificity is 95% while laparoscopy has both sensitivity and specificity of 100%. USG and laparoscopy, both have 100% sensitivity and specificity in diagnosing ectopic pregnancy, para-ovarian cyst and TO abscess. Benign serous cystadenoma is a histopathological diagnosis and is missed by both laparoscopy and ultrasonography.

Conclusions: Ultrasonography should be the primary imaging modality used to identify and characterize adnexal masses, as it is readily available, and noninvasive.


Nezhat F, Nezhat C, Welander CE, Benigno B. Four ovarian cancers diagnosed during laparoscopic management of 1011 women with adnexal masses. Am J Obstet Gynecol. 1992;167:790-6.

Yazbek J, Raju S, Nagi J, Holland T, Hillaby K, Jurkovi D. Effect of quality of gynaecological ultrasonography on management of patients with suspected ovarian cancer: a randomised controlled tria. The Lancet Oncol. 2008;9(2):124-31.

De Kroon CD, van der Sandt HA, van Houwelingen JC, Jansen FW. Sonographic assessment of non-malignant ovariancysts: does sonohistology exist? Hum Reprod. 2004;19:2138-43.

Valentin L, Ameye L, Jurkovic D, Metzger U, Lécuru F, Van Huffel S, et al. Which extrauterine pelvic masses are difficult to correctly classify as benign or malignant on the basis of ultrasound findings and is there a way of making a correct diagnosis? Ultrasound Obstet Gynecol. 2006;27(4):438-44.

Theodoridis TD, Zepiridis L, Mikos T, Grimbizis GF, Dinas K, Athanasiadis A, et al. Comparison of diagnostic accuracy of transvaginal ultrasound with laparoscopy in the management of patients with adnexal masses. Arch Gynecol Obstet. 2009;280(5):767-73.

Pleş L, Sima RM, Burnei A, Albu DF, Bujor MA, Conci S, et al. The experience of our clinic in laparoscopy for adnexal masses and the correlation between ultrasound findings and pathological results. Rom J Morphol Embryol. 2016;57(4):1337-41.

Bhagde AD, Jani SK, Patel MS, Shah SR. An analytical study of 50 women presenting with an adnexal mass. Int J Reprod Contracept Obstet Gynecol. 2016;6(1):262.

Aggarwal K. Laparascopic evaluation and management of benign adnexal masses. J Med Sci Clin Res. 2017;5(6):23024-30.

Yogini KD, Balasubramaniam D, Palanivelu C, Kakollu A. Laparoscopic approach to adnexal mass in adolescents: a retrospective analysis. J Datta Meghe Inst Med Sci Univ. 2017;12(1):55-60.

Yadav P, Gupta M, Agarwal M, Garg R, Verma U, Gupta S. Role of imaging in dilema of adnexal masses in postmenopausal women. J South Asian Feder Menopause Soc. 2017;5(1):45-50.

Wakhloo A, Sharma S, Singh G. Role of laparoscopy in the diagnosis and management of benign adnexal masses. Int J Res Med Sci. 2019;7:255-9.






Original Research Articles