Ultrasound and the pelvic mass.

ABSTRACT

We compared the findings from pelvic examination, preoperative ultrasound and surgery on 50 patients who underwent exploratory laparotomy for a pelvic mass at Tulane University Medical Center. Of the 50 cases, 34 (68%) were correctly diagnosed as a pelvic mass by both pelvic examination and ultrasonography. Ultrasound had nine false negatives (21%) and only one false positive (2%). Pelvic examination had 7 false positives (16%). There was no statistical difference by chi-square analysis in the accuracy between ultrasonography and pelvic examination in the detection or diagnosis of the masses. Ultrasound indicated pathology not associated with the suspected mass in ten patients; surgery confirmed pathology in five of them. More errors occurred on both pelvic examination and ultrasonography in obese patients than in nonobese ones seven of the ten ultrasound errors occurred in obese patients, and five of the seven pelvic exam errors also occurred in obese patients. In the nine cases of false-negative ultrasound findings surgery was postponed, but all of them eventually underwent surgery because of a deteriorating clinical course. In our study pelvic ultrasonography was not beneficial in the management of patients with a known or suspected pelvic mass, but it was very accurate for confirmation of a mass.