Ayesha Azam Khan, Naheed Bashir, Raza Akram, Nabeela Shami, Shaila Anwar, Shaheena Asif, Lubna Abid.
Transvaginal Sonographic Diagnosis of Ovarian Endometrioma.
Pak J Med Health Sci Jan ;7(1):22-6.

Aim: To determine the diagnostic performance of specific ultrasound features in discriminating endometriomas from other adnexal masses. Study design: A retrospective study was conducted from Jan 2009 To Jan 2012 in 65 patients coming to Surgimed Infertility Centre, Lahore. Methods: Patients with >25 years of age, infertile women with endometrioma, who underwent laparotomy or laparoscopy were included in the study while patients with pelvic inflammatory disease, ectopic pregnancy were excluded. All patients had prospective evaluation by transvaginal scan. Ultrasonographic criteria for diagnosing endometrioma were round shaped, cystic structure in adnexa, diffuse low level internal echoes, multilocularity, hyperechoic wall foci and wall thickness were noted. Results: Histopathological findings of adnexal mass were endometrioma (n=40), dermoid cyst (n=3), haemorhagic cyst (n=6), malignancy (n=2) and benign cyst (n=2). Among benign cyst cases of ovarian torsion n=1, broad ligament haematoma n=1, paratubal cyst n=1, hydrosalpinx n=1 and single functional cyst n=7. The results were analyzed statistically it was found that sensitivity of TVS for diagnosing endometrioma was 86% specificity 90%; the positive predictive value 91% and negative predictive value 98%. Conclusion: An adnexal mass with diffuse low level internal echoes and absence of particular neoplastic feature is highly suggestive of endometrioma if multilocularity/hyper echoic wall foci present.

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