EFFICACY OF TRANSVAGINAL SONOGRAPHY IN DIAGNOSIS OF OVARIAN ENDOMETRIOMA

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