P27.03: Three-dimensional power Doppler US using VOCAL method can help distinguish endometriomas from haemorrhagic cyst?

To retrospectively evaluate the diagnostic accuracy of power Doppler three-dimensional (3D-PD) ultrasound in discrimination between endometriomas and hemorrhagic cyst. A total of 111 patients with adnexal cystic mass were recruited. Three-dimensional power Doppler US images of 111 cystic masses (66 endometriomas and 45 haemorrhagic cysts) were obtained using a Voluson Expert® (G.E) ultrasound system. The Virtual Organ Computer-aided AnaLysis (VOCAL) imaging program was used to analyze the stored volume. Histogram values of the vascularization index (VI), flow index (FI) and vascularization-flow index (VFI) were calculated. All 66 patients with endometriomas underwent surgery with pathological confirmation; sonographic follow-up was performed in the remaining 45 haemorrhagic cysts and mean duration follow-up was 3 months (range, 1–6 months). The mean age of the endometriomas group was 35.8 ± 6.8 and of 38.5 ± 6.8 (p < 0.05) for those with haemorrhagic cysts. The volume of the endometriomas and haemorraghic cysts was respectively 31.4 ± 27.5 cc and 22 ± 17.10 cc (p: n.s). Mean values of vascular indices were 1.795%2.495 ± vs 5.192% ± 5.718 (VI), 32.695 ± 9.770 vs 37.549 ± 8.795 (FI) and 0.735 ± 1.131 vs 2.257 ± 2.933 (VFI) with p < 0.001 for all three values. The vascular indices of haemorrhagic cysts were significantly higher than those of endometriomas. Histogram indices in the 3D power Doppler scan can aid in distinguishing between endometriomas and haemorrhagic cysts. Our data suggest that haemorraghic cysts have higher VI, FI and VFI than endometriomas, with statistical significance.