Tirsit S Asfaw1, Joy A Greer, Parvati Ramchandani, Megan O Schimpf. 1. Department of Obstetrics and Gynecology, Division of Urogynecology, New York Presbyterian Hospital/Weill Cornell Medical Center, 525 East 68th Street, J-130, New York, NY 10065, USA. tirsit@yahoo.com
Abstract
INTRODUCTION AND HYPOTHESIS: The clinical evaluation of anterior vaginal wall masses can present a dilemma, as there are no well-defined pathways for diagnosis and management. Our objective was to evaluate the role and accuracy of preoperative exam and magnetic resonance imaging (MRI) for these masses. METHODS: We identified women with a mass using billing codes for 10 years. We compared data from the preoperative evaluation to postoperative pathology if available. RESULTS: Analysis after chart review on 47 women was performed. Of the 34 women who had surgery, 28 (82.4%) also underwent an MRI. MRI diagnosis was accurate in 22/28 women compared to histology, inconclusive in 4, and inaccurate in 2. Preoperative diagnosis, including exam, MRI, and cystourethroscopy, had a diagnostic accuracy of 94.1% compared to postoperative diagnosis. The positive predictive value of MRI alone was 91.7%. CONCLUSIONS: Preoperative diagnosis using exam, MRI, and cystourethroscopy have a high diagnostic accuracy for anterior vaginal wall masses.
INTRODUCTION AND HYPOTHESIS: The clinical evaluation of anterior vaginal wall masses can present a dilemma, as there are no well-defined pathways for diagnosis and management. Our objective was to evaluate the role and accuracy of preoperative exam and magnetic resonance imaging (MRI) for these masses. METHODS: We identified women with a mass using billing codes for 10 years. We compared data from the preoperative evaluation to postoperative pathology if available. RESULTS: Analysis after chart review on 47 women was performed. Of the 34 women who had surgery, 28 (82.4%) also underwent an MRI. MRI diagnosis was accurate in 22/28 women compared to histology, inconclusive in 4, and inaccurate in 2. Preoperative diagnosis, including exam, MRI, and cystourethroscopy, had a diagnostic accuracy of 94.1% compared to postoperative diagnosis. The positive predictive value of MRI alone was 91.7%. CONCLUSIONS: Preoperative diagnosis using exam, MRI, and cystourethroscopy have a high diagnostic accuracy for anterior vaginal wall masses.
Authors: E S Siegelman; E K Outwater; M P Banner; P Ramchandani; T L Anderson; M D Schnall Journal: Radiographics Date: 1997 Sep-Oct Impact factor: 5.333