The Role of Ultrasonography and Magnetic Resonance Imaging in the Evaluation of Adnexal Masses With Histopathological Correlation.

BACKGROUND

Accurate evaluation of adnexal masses is crucial for appropriate management, distinguishing benign from malignant lesions, and guiding surgical planning. Ultrasonography (USG) is commonly used as a first-line modality, while magnetic resonance imaging (MRI) provides detailed tissue characterization. This study aimed to compare the diagnostic performance of USG and MRI in the assessment of adnexal masses and to correlate imaging findings with histopathological examination (HPE).

METHODS

A prospective study was conducted on 67 patients presenting with adnexal masses. All patients underwent USG and MRI evaluation, including assessment of tumor size, surface, septations, solid components, vascularity, ascites, and lymphadenopathy. Imaging findings were correlated with HPE results. Diagnostic performance metrics, such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, were calculated for each modality.

RESULTS

USG identified 76.1% of masses as benign and 23.9% as malignant, while MRI identified 79.1% as benign and 20.9% as malignant. MRI demonstrated higher sensitivity (98.2% vs 92.6%), specificity (100% vs 92.3%), PPV (100% vs 98.0%), NPV (92.9% vs 75.0%), and overall diagnostic accuracy (98.5% vs 92.5%) compared with USG. MRI also better detected septations, solid components, ascites, and lymphadenopathy. Histopathology confirmed that benign cystic lesions were the most common pathology, with a small proportion of malignant tumors. The correlation between USG and MRI findings showed high agreement, indicating the reliability of USG as an initial assessment tool.

CONCLUSION

USG is a dependable first-line imaging modality for evaluating adnexal masses, while MRI provides superior diagnostic confidence, particularly in complex or suspicious cases. Combined imaging and histopathological correlation optimize diagnostic accuracy, guide surgical planning, and improve patient outcomes.