EFFICACY OF TRANSVAGINAL SONOGRAPHY IN DIAGNOSIS OF OVARIAN ENDOMETRIOMA

1Dr Mahnoor Shah, 2Dr Mehwish Niaz, 3Dr Javeria Noreen
2020 · doi:10.5281/zenodo.4332316 · W6968485977
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⚙ AI-generated summary by claude@2026-07, 2026-07-15 ⓘ

Transvaginal sonography demonstrated 86% sensitivity and 90% specificity in diagnosing ovarian endometriomas, with specific ultrasound features aiding discrimination from other adnexal masses.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-15 · read from full text ⓘ

This retrospective study evaluated the diagnostic performance of specific transvaginal ultrasound (TVS) features for distinguishing ovarian endometriomas from other adnexal masses in infertile women aged over 25 years, who underwent prospective TVS assessment and subsequent laparotomy or laparoscopy, while excluding pelvic inflammation and ectopic pregnancy. Using ultrasound criteria such as a round cystic adnexal shape, diffuse low-level internal echoes, multilocularity, and hyperechoic wall foci (with attention to wall thickness), histopathology categorized masses including 40 endometriomas and several other benign and malignant entities. TVS showed sensitivity of 86%, specificity of 90%, positive predictive value of 91%, and negative predictive value of 98%. This paper is centrally about endometriosis — it focuses on TVS features and diagnostic accuracy for ovarian endometrioma.

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Abstract

Aim: To determine the diagnostic performance of specific ultrasound features in discriminating endometriomas from other adnexal masses. Study design: A retrospective study was conducted in the Department of Obstetrics & Gynecology, Sir Ganga Ram Hospital, Lahore for one-year duration from August 2019 to August 2020. Methods: Patients> 25 years of age were included in the study, infertile women with endometriomas who underwent laparotomy or laparoscopy, while patients with pelvic inflammation and ectopic pregnancy were excluded. All patients were prospectively assessed by a transvaginal study. The ultrasound criteria for the diagnosis of endometrioma are: 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), hemorrhagic cyst (n=6), malignancy (n=2) and benign cyst (n=2). Among benign cyst cases of ovarian torsion n=1, broad ligament hematoma n=1, para-tubal 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. Keywords: TVS, endometrioma, adnexal mass.
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Methods

Patients> 25 years of age were included in the study, infertile women with endometriomas who underwent laparotomy or laparoscopy, while patients with pelvic inflammation and ectopic pregnancy were excluded. All patients were prospectively assessed by a transvaginal study. The ultrasound criteria for the diagnosis of endometrioma are: 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), hemorrhagic cyst (n=6), malignancy (n=2) and benign cyst (n=2). Among benign cyst cases of ovarian torsion n=1, broad ligament hematoma n=1, para-tubal 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.

Keywords

TVS, endometrioma, adnexal mass. Files 198.Af5-converted.pdf Files (321.1 kB) | Name | Size | Download all | |---|---|---| | md5:df694b892cc25b7a3323a05af830bf7d | 321.1 kB | Preview Download |

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