The parameters affecting accuracy of e ultrasonographic diagnosis in dermoid cysts

• Main Authors: Yeşim Bayoğlu Tekin, Şadıman Kıykaç Altınbaş, F. Suat Dede, Berna Dilbaz
• Format: Article
• Language: English
• Published: Dicle University Medical School 2014-03-01
• Series: Dicle Medical Journal
• Subjects: Dermoid cyst; ultrasonography; pattern recognition method
• Online Access: http://www.diclemedj.org/upload/sayi/31/Dicle%20Med%20J-01814.pdf
• ISSN: 1300-2945; 1308-9889

Objective: To determine the adequacy of ultrasound in diagnosis of dermoid cysts and to demonstrate the causes of ultrasonographic failure in histopathologically misdiagnosed cases. Methods: Of 245 consecutive patients, whom an adnexal mass is determined and the preliminary ultrasonographic diagnosis of the cyst was a dermoid csyt, were included in the study. Preoperative ultrasonographic findings and postoperative pathology results were evaluated and the correlation with pre-operative ultrasound imaging and final pathologic results were analyzed. Results: The diagnosis of a dermoid cyst with ultrasonography was detected with the following rates of sensitivity 81.8%, specifity 93.1%, positive predictive value 67.5%, negative predictive value 96.7%. A wall thickness greater than 3 mm (p=0.029), inner wall irregularity (p=0.001), mixed echogenity according to hyperechogenic lines p=0.003), solid component (p=0.001), acoustic shadowing (p=0.001), calcification (p=0.001), echogenic mural nodule (p=0.001), were found to be statistically significant (p<0.001) in ultrasonographic diagnosis of dermoid cysts. Determination of vascularity in Doppler sonography was not found statistically significant in diagnosis of dermoid cysts (p=0.52). Conclusion: Pattern recognition method is a method that evaluates and diagnoses adnexal masses by ultrasonography subjectively. It was shown to be more reliable with high accuracy rates in specific diagnosis of adnexial masses when compared to that of other methods. Even though hyperechogenic lines and hyperechogenic solid masses were characteristic findings for dermoid cysts, these parameters were found to be the most frequent causes of misdiagnosis.