Differential Diagnosis of Adnexal Masses with Transvaginal Sonography, Color Flow Imaging, and Serum CA 125 Assay in Pre- and Postmenopausal Women

Abstract

The aim of the present study was to compare the diagnostic accuracy of transvaginal sonography, color flow imaging, and serum CA 125 assay in pre- and postmenopausal women undergoing laparotomy for a clinical diagnosis of an adnexal mass. In 109 consecutive women, the morphology of the mass was evaluated with transvaginal sonography, the pulsatility index (PI) was computed on the arteries detected with color flow imaging, and blood samples were obtained for CA 125 assay. Descriptive statistics were performed for the whole series and according to the menopausal status. The diagnostic accuracy of transvaginal sonography was significantly higher in premenopause than in postmenopause (97 versus 85%,P< 0.05). In premenopause, the diagnostic accuracy of transvaginal sonography was significantly higher than that of PI measurement (73%,P< 0.002) and serum CA 125 assay (87%,P< 0.05). In postmenopause, the three tests showed a similar diagnostic accuracy (85, 82, and 79%, respectively). In conclusion, the addition of further tests besides transvaginal sonography is not warranted in premenopausal women with an adnexal mass, but they seem to be useful in postmenopause.