Role of ultrasonography in evaluation of right iliac fossa mass compared to CT scan

Abstract

Background: With the demonstration of origin and nature of RIF mass by high-resolution ultrasound and multidetector CT scan, the patients presenting with clinically palpable mass in RIF need not to undergo time consuming, uncomfortable and unpalatable barium study. The objective is to evaluate the diagnostic precision of CT and ultrasonography in the diagnosis of right iliac fossa masses and to assess the effectiveness of USG in diagnosing various right iliac fossa masses in comparison with CT scan in terms of sensitivity, specificity, and predictive accuracy.

Methods: The study was conducted on 35 patients presenting with right iliac fossa mass who were stable enough to undergo USG followed by CT scan. The time gap between these studies had kept to minimum to make the studies comparable. USG and CT scan was performed by 2 expert radiologists, who had been blinded of each other findings.

Results: More than 50% cases were related to appendicular pathology. Ultrasound abdomen had a sensitivity and specificity of 88.9% and 94.11% in diagnosis of appendicular mass, 71.42% and 96.42% in diagnosis of appendicular abscess, 66.7% and 96.6% in diagnosis of ileo-caecal tuberculosis, 50% and 100% in diagnosis of carcinoma caecum respectively as compared to CT scan.

Conclusions: USG is the most easily available bed side investigation and excellent screening test for RIF mass. However, CECT whole abdomen remains the gold standard investigation for etiological diagnosis of RIF mass.