Assessment of cyst content using mean gray value for discriminating endometrioma from other unilocular cysts in premenopausal women

Juan Luis Alcázar, Alcázar Jl, J. L. Alcázar, León M, M. León, Moisés León, Galván R, R. Galván, S. Guerriero
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2009 · vol. 35(2) , pp. 228–232 · doi:10.1002/uog.7535 · PMID:20066720 · W2009304309
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Mean gray value (MGV) of cyst content was significantly higher in ovarian endometriomas compared to other unilocular cysts, with diagnostic performance similar to subjective B-mode assessment.

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Abstract

OBJECTIVE: To assess whether the analysis of cyst content using mean gray value (MGV) can discriminate ovarian endometriomas from other unilocular ovarian cysts in premenopausal women. METHODS: Stored three-dimensional (3D) volumes from 54 unilocular ovarian cysts diagnosed in 50 premenopausal women (mean age, 37 (range, 22-50) years) were analyzed to calculate the MGV from cyst content. Cysts with solid components or septations were excluded. MGV was calculated in all cases with the Virtual Organ Computer-aided AnaLysis technique. The B-mode presumptive diagnosis based on the examiner's subjective impression was also recorded. RESULTS: Sixteen of the cysts resolved spontaneously and were given a final clinical diagnosis of hemorrhagic functional cyst, while 38 cysts were removed surgically (diagnosed histologically as seven simple cysts, three hemorrhagic cysts, 20 endometriomas, five mucinous cysts and three paraovarian cysts). B-mode diagnoses were as follows: seven simple cysts, 18 hemorrhagic cysts, 24 endometriomas, three mucinous cysts and two paraovarian cysts. MGV was significantly higher in ovarian endometrioma when compared with all other kinds of cyst. The receiver-operating characteristics curve showed that using an MGV cut-off >or= 15.560 had a sensitivity of 85% and a specificity of 76.5% for diagnosing ovarian endometrioma (area under the curve, 0.831; 95% CI, 0.718-0.944). These figures were similar to those for B-mode diagnosis (sensitivity, 90%; specificity, 82%) (McNemar test, P = 1.000). Combining B-mode and MGV gave a sensitivity of 80% and a specificity of 91%. CONCLUSION: Cyst content MGV is higher in ovarian endometrioma than it is in other unilocular ovarian cysts. The diagnostic performance of MGV is similar to that of the examiner's subjective impression. The combination of both criteria achieves the highest specificity.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Ovarian Cysts Ovarian Diseases Adult Endometriosis Endometriosis Female Humans Middle Aged Ovarian Cysts Ovarian Cysts Ovarian Diseases Ovarian Diseases Premenopause Reproducibility of Results Retrospective Studies Sensitivity and Specificity Treatment Outcome Ultrasonography Young Adult

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