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Ongeti et al  

Full Length Research Paper

Validity of Clinical Evaluation versus Sonographic Findings compared to Surgical Outcomes as a Gold Standard of Gynecological Masses in Patients referred for Pelvic Ultrasonography at Moi Teaching and Referral Hospital in Eldoret, Kenya

 

Connie M. Ongeti1, Joseph M. Abuya1* and Hillary M. Mabeya2

1Department of Radiology and Imaging, Moi University, P. O. Box 4606 30100, Eldoret, Kenya.
1Department of Reproductive Health, Moi University, P. O. Box 4606-30100, Eldoret, Kenya.

 

Corresponding author email: abuyajm@yahoo.com; Tel: +254 722 802926

Received September 4, 2017; Accepted September 26, 2017

 

ABSTRACT
Gynecologic pelvic masses are a significant cause of morbidity and mortality in women, with a prevalence ranging from 8% to 56%. The diagnosis of these masses heavily relies on sonography. Since clinical management decisions are based on sonography, the validity of pre-operative ultrasound results of gynecologic pelvic masses is important. To establish the common clinical presentations, sonographic and surgical findings in women sent for sonography in the evaluation of gynecologic pelvic masses. A cross sectional study was conducted from October 2013 to October 2014 at Moi Teaching and Referral Hospital, in Eldoret, Kenya. Sixty-nine patients with gynecologic masses, who had been examined clinically, had pelvic ultrasound done and subsequently underwent surgery were enrolled. Clinical and sonographic findings were evaluated and compared with the surgical outcome. Data was collected using a structured questionnaire. Analysis was done using Stata version 11. Frequencies, measures of central tendency, sensitivity, specificity and predictive values were calculated. Mean age of participants was 44.4 years (standard deviation = 14.9). Ultrasound sensitivity was; uterine fibroids (95.2%), ovarian cysts (68.8%), dermoid cysts (60%) and endometrial cancer (33.3%). Ultrasound specificity was; uterine fibroids (81.3%), ovarian cysts (94.2%), dermoid and ovarian cysts (96.9%). Sonographic positive predictive value was: uterine fibroids (68.9%), ovarian cysts (78.6%), ovarian cancer and dermoid cysts (60%). The area under the curve for sonography was higher than that of clinical examination for ovarian cyst (0.82 compared to 0.58), dermoid cyst (0.86 compared to 0.49) and ovarian cancer (0.78 compared to 0.67). Most common clinical presentation was abdominal pain and swelling. The accuracy of sonography was significantly higher than clinical examination in the evaluation of uterine masses and ovarian cancer. Sonography had high sensitivity in predicting the organ of origin of a gynecologic mass. Sonographic specificity was high across all the gynecologic masses.

Keywords:
Validity, Clinical evaluation, Sonographic findings, Surgical outcomes, Gynecological masses, Moi Teaching and Referral Hospital, Kenya.

 

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