IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 18, Issue 3 Ser. 3 (March. 2019), PP 66-71 www.iosrjournals.org DOI: 10.9790/0853-1803036671 www.iosrjournals.org 66 | Page Analysing Two Bulky Eggs In An Eagles Nest: Analysis Of Unenhanced & Contrast Enhanced Computed Tomography Study Of Adnexa To Reduce Radiation Exposure In Adnexal Pathologies. Dr Nupur Basu 1 , Dr Preetam Debasish Panda 2 1 Asst.Prof Dept of Radiodiagnosis Medical College and Hospital ,Kolkata. 2 Junior resident Dept of Radiodiagnosis Medical College and Hospital Kolkata. Corresponding Author: Dr Preetam Debasish Panda Abstract: The primary goal of imaging study is to detect an abnormality, then characterize whether malignant or benign.Various modalities have been established,each having their own pros and cons.When it comes to gynecological imaging ,USG has dominated the imaging studies of female pelvis due to its easy accessibility, feasibility, most importantly it has limited radiation hazards, but has its own limitations.CT,a relatively new approach uses multidetector computed tomography (MDCT), which allows thinner sections, faster imaging, and good spatial resolution, has led to its more common use for further characterization of adnexal mass and staging work-up of ovarian malignancy 2-4 . CT protocol for the evaluation of abdomen and pelvis has even adopted multiphase CT scans, including scanning before and after contrast administration . Considering the dose-multiplication effect of extra phase, it is certain that inappropriate multiphase CT can be an important source of excess radiation exposure 5 . The purpose of this study is to compare the diagnostic efficacy and radiation dose of contrast-enhanced CT (CECT) alone with that of combined unenhanced and enhanced CT (UE + CECT), for the assessment of adnexal mass. Keywords: computed TOMOGRAPHY(CT),UNENHANCED(UE),CONTRAST ENHANCED (CE) --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 22-02-2019 Date of acceptance: 08-03-2019 --------------------------------------------------------------------------------------------------------------------------------------- I. Materials And Methods This retrospective study was carried out at a tertiary care hospital -Medical College and Hospital, Kolkata , after the study protocol was approved by the Ethics Committee. Diagnosed cases of ovarian cancer by usg/histopathology referred for CT scan evaluation from gynecology/ Radiotherapy department were considered. The study was carried out from November 2017 to december 2018 and during this period 73 consecutive patients aged 20 to 80 years who gave written informed consent were included in this study. A total of 84 patients who did not give consent and did not turn up during the follow up were excluded. Patients underwent contrast enhanced CT of abdomen and pelvis on 16 slice multi-detector CT scanner ( Siemens) as per the standard protocol 11 ,120 kV and 160 mAs using Iohexol .Scans covered the thoracic cavity to the symphysis pubis. Delayed scans were performed in cases with suspicion of bladder involvement. The indications for CT examination of all patients were as follows: evaluation of known ovarian tumor or adnexal mass (n = 43), evaluation of pelvic mass of unknown origin (n = 2), large amount of ascites (n = 2), lower abdominal or pelvic pain (n = 23), staging of non-ovarian malignancy (n = 3). Non-ovarian malignancy included cervix cancer (n = 2), endometrial cancer (n = 1). Images obtained were analyzed by two experienced radiologists. II. Imaging Analysis The CT images were reviewed retrospectively on a picture archiving and communication system workstation by two radiologists with years of experience, respectively, in genitourinary and abdominal imaging independently. The readers were aware that the patients had undergone surgery/chemoradiation for adnexal mass, but they were blinded to the laterality of the surgery and any other clinical, pathologic, or radiologic findings of all patients. Both readers independently reviewed CECT images alone and UE + CECT images. The two data sets in each patient were randomly interpreted in different sessions at 4-week intervals. In each patient, both adnexa were evaluated for the presence of mass and the presence or absence of a mass in each adnexa was recorded. If an adnexal mass was regarded as being present, the size of the largest dimension at transverse scan was measured.