ACR Appropriateness Criteria® clinically suspected adnexal mass.
Publication/Presentation Date
3-1-2013
Abstract
Adnexal masses are a common problem clinically and imaging-wise, and transvaginal US (TVUS) is the first-line imaging modality for assessing them in the vast majority of patients. The findings of US, however, should be correlated with the history and laboratory tests, as well as any patient symptoms. Simple cysts are uniformly benign, and most warrant no further interrogation or treatment. Complex cysts carry more significant implications, and usually engender serial ultrasound(s), with a minority of cases warranting a pelvic MRI.Morphological analysis of adnexal masses with gray-scale US can help narrow the differential diagnosis. Spectral Doppler analysis has not proven useful in most well-performed studies. However, the use of color Doppler sonography adds significant contributions to differentiating between benign and malignant masses and is recommended in all cases of complex masses. Malignant masses generally demonstrate neovascularity, with abnormal branching vessel morphology. Optimal sonographic evaluation is achieved by using a combination of gray-scale morphologic assessment and color or power Doppler imaging to detect flow within any solid areas.The ACR Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
Volume
29
Issue
1
First Page
79
Last Page
86
ISSN
1536-0253
Published In/Presented At
Harris, R. D., Javitt, M. C., Glanc, P., Brown, D. L., Dubinsky, T., Harisinghani, M. G., Khati, N. J., Kim, Y. B., Mitchell, D. G., Pandharipande, P. V., Pannu, H. K., Podrasky, A. E., Royal, H. D., Shipp, T. D., Siegel, C. L., Simpson, L., Wall, D. J., Wong-You-Cheong, J. J., Zelop, C. M., & American College of Radiology (2013). ACR Appropriateness Criteria® clinically suspected adnexal mass. Ultrasound quarterly, 29(1), 79–86. https://doi.org/10.1097/RUQ.0b013e3182814d9b
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
23358212
Department(s)
Administration and Leadership
Document Type
Article