Ultrasound Features to Distinguish Endometrioma from Other Pelvic Masses

Purpose: To evaluate diagnostic accuracy of ultrasound findings in the diagnosis and discrimination of endometriomas from other adnexal masses. Materials and methods: Ultrasound examination of 120 adnexal masses in 98 women was done and findings were recorded on a check list. Philips HDI 5000 and I21 ultrasound machines were used. Diagnostic features which can discriminate endometriomas from other pelvic masses were reviewed. Results: There were 30 endometriomas. Diffuse low-level internal echoes were present in 29 (97%) of endometriomas and in 5 (17%) nonendometriomas.. The presence of multilocularity or hyperechoic wall foci further increased the positive likelihood ratio to 35, allowing the identification of 15 endometriomas (50%). Conclusion: ultrasound features of diffuse low level echoes, echogenic wall and multilocularity has a high positive predict value in the diagnosis of endometrioma and helping it in discrimination from other pelvic masses. Endometriomas exhibits wide range of ultrasound features, ranging from anechoic to echogenic cysts to masses containing multiple septations and solid tissue.