Diagnostic utility of abdominal ultrasound in the evaluation of abdomino-pelvic lesions at Bugando Medical Centre in Mwanza, Tanzania

Abstract

Background: Despite the fact that abdominal ultrasound has been widely used in many centres in Tanzania as a primary diagnostic imaging for patients with abdomino-pelvic lesions, its diagnostic utility has not yet been assessed in Tanzania, and therefore its use as an alternative diagnostic tool in patients with abdomino-pelvic lesions is not justified. This study aimed to determine the utility of abdominal ultrasound in the diagnosis of abdomino-pelvic lesions in our local setting.

Methods: This was a cross sectional study to evaluate the diagnostic utility of abdominal ultrasound in patients presenting with abdomino-pelvic lesions at Bugando Medical Centre between January 2017 and July 2017. Abdominal ultrasonographic findings were cross-tabulated against operative findings (the gold standard). Then, the sensitivity, specificity, accuracy, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy were calculated to determine the diagnostic utility of abdominal ultrasound.

Results: A total of 146 patients (M: F ratio = 1: 2.2) were studied. The mean age at diagnosis was 39.3 years. The diagnostic utility of abdominal ultrasound in terms of sensitivity, specificity, PPV, NPV and accuracy were 39.4-100%, 0-100%, 64.7-100%, 0-100% and 40.8-100% respectively.  The kappa statistic (қ) showed good to excellent agreement with the operative findings, the gold standard (қ = 0.75-1.00).

Conclusion: The diagnostic utility of abdominal ultrasound in detecting abdomino-pelvic lesions is much lower than that seen in developed countries, hence, abdominal ultrasound is not a reliable tool in detecting abdomino-pelvic lesions at Bugando Medical Centre and therefore its use should be supplemented with abdominal CT scan in selected cases.