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Scoring system for prediction of ovarian endometriosis based on transvaginal color and pulsed Doppler sonography
Objective:
To develop a new noninvasive scoring system using clinical signs and symptoms, CA-125 levels, sonographic findings, and transvaginal color and pulsed Doppler parameters for preoperative recognition of ovarian endometriosis.
Design:
A 5-year prospective study in patients undergoing laparotomy and laparoscopy.
Setting:
Department of Obstetrics and Gynecology, University of Zagreb, Sveti Duh Hospital, Zagreb, Croatia.
Patients:
Six hundred fifty-six benign and malignant adnexal masses, among which 103 were surgically proved to be ovarian endometriosis.
Interventions:
All patients undergoing laparotomy and laparoscopy were examined by transvaginal ultrasonography with color Doppler imaging. Serum levels of CA-125 were measured the day before surgery.
Main Outcome Measure:
The total score was applied in all patients with adnexal masses.
Results:
The scoring system proved to be very useful in distinguishing ovarian endometriosis from other benign and malignant ovarian lesions, with a sensitivity of 99.02% and a specificity of 99.64%, compared with morphological scoring system's sensitivity of 83.91% and specificity of 97.12%.
Conclusion:
The new noninvasive scoring system improves significantly the ability to discriminate between endometriosis and other benign and malignant ovarian entities.