FIRST OF FOUR PARTS

Skilled US imaging of the adnexal mass
Part 1: Starting point

Whether you scan the patient yourself or refer her
to an ultrasonography lab, you need to be able
to identify both physiologic and pathologic structures

Dr. Timor-Tritsch is Professor of ObGyn and Director of ObGyn Ultrasound at New York University Medical Center in New York City.

Dr. Goldstein is Professor of ObGyn, Director of Gynecologic Ultrasound, and Co-Director of Bone Densitometry at New York University Medical Center in New York City. He serves on the OBG Management Board of Editors.

Dr. Timor-Tritsch reports no financial relationships relevant to this article. Dr. Goldstein reports that he is an advisor to Amgen, Boehringer Ingelheim, Eli Lilly, Novo Nordisk, Merck, and Pfizer. He also serves as a consultant to Cook ObGyn and Philips Ultrasound and as a speaker for Eli Lilly and Warner Chilcott. He is a director of Sonosite, Inc.

No doubt about it: Scanning the adnexae is the most challenging task in gynecologic ultrasonography (US). There are many reasons for the difficulty, but probably none more important than the fact that you are expected to reach a conclusion about what you see—or at least narrow the differential diagnosis.