Transvaginal sonographic diagnosis of ovarian endometrioma

OBJECTIVE: To assess the efficacy of transvaginal sonography (TVS) in differentiating endometriomas from other adnexal masses. METHODS: One thousand thirty-five adnexal masses undergoing laparoscopy or laparotomy were evaluated prospectively using TVS. Masses diagnosed as endometrioma according to their sonographic appearance were divided into two groups: those with a round shape, regular margins, thick walls and homogeneous, low-level echoes (group A); or those with irregular margins, internal septations and an anechoic appearance (group B). RESULTS: The sensitivity of TVS in diagnosing endometriomas was 86.50% and the specificity 99.11%. The positive predictive value (PPV) and the negative predictive value of the test were calculated to be 91.45% and 98.14%, respectively. By using the criteria determining group A, the PPV of the test increased to 97%, whereas group B had a lower PPV (70.85%). CONCLUSION: We propose that the accuracy of TVS in diagnosing endometriomas may be beneficial in various clinical conditions.