Ovarian Endometriosis
Ovarian endometriosis, appearing as a cystic lesion with "ground-glass" echogenicity on ultrasound, is commonly known as an ovarian endometrioma or "chocolate cyst."
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This chapter describes ovarian endometriosis (endometriomas or “chocolate cysts”) and highlights its typical transvaginal ultrasound appearance as a cystic adnexal lesion with “ground-glass” echogenicity lacking papillary projections or solid components. It synthesizes prior diagnostic accuracy studies and ultrasound feature work, noting that techniques such as acoustic streaming or Doppler-based approaches have variable discriminative performance, and that cyst appearance can be part of a broader spectrum of ovarian pathology. A key caveat is that imaging findings overlap with other benign lesions and diagnostic performance depends on lesion characteristics and patient context, which limits specificity. This paper is centrally about endometriosis — it focuses on the ultrasound characterization and diagnostic imaging features of ovarian endometriosis/endometriomas, a core subtype of endometriosis.
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