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Endometriomas: diagnostic performance of US.
M D Patel1, V A Feldstein, D C Chen
1Department of Radiology, University of California, San Francisco, USA.
Radiology
|April 20, 1999
Summary
Specific ultrasonographic (US) features can help differentiate endometriomas from other adnexal masses. Diffuse low-level internal echoes, absence of neoplastic features, and presence of multilocularity or hyperechoic wall foci strongly suggest endometrioma.
Area of Science:
- Gynecologic imaging
- Diagnostic ultrasound
Background:
- Endometriomas are common gynecologic conditions.
- Accurate differentiation from other adnexal masses is crucial for appropriate management.
Purpose of the Study:
- To evaluate the diagnostic performance of specific ultrasonographic (US) features.
- To assess the ability of US to discriminate endometriomas from other adnexal masses.
Main Methods:
- Two sonologists independently reviewed 252 adnexal masses in 226 women.
- Standardized checklist used to record US features.
- Diagnostic performance of US features and reviewer impression evaluated.
Main Results:
- Diffuse low-level internal echoes were present in 95% of endometriomas.
- Excluding neoplastic features increased the positive likelihood ratio for endometrioma diagnosis.
- Multilocularity or hyperechoic wall foci significantly increased the positive likelihood ratio.
Conclusions:
- Diffuse low-level internal echoes, absence of neoplastic features, and presence of multilocularity or hyperechoic wall foci are highly suggestive of endometrioma.
- Patients with masses exhibiting these US features may require further imaging for definitive diagnosis.