Transvaginal Ultrasonography Combined with Pelvic Examination in the Diagnosis of Ovarian Endometrioma
SAWAEK WEERAKIET, M.D.*, MANA ROCHANA WUTANON, M.D.**, ANNA WONGKULARB, M.Sc.*, ARAM ROJANASAKUL, M.D.*
Affiliation : * Department of Obstetrics and Gynecology, ** Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
The aim of this retrospective study was to evaluate the efficacy of TVS and TVS combined
with ~elvic examin<(tion for the diagnosis of ovarian endometrioma. Three hundred and five
ovarian masses of 244 patients with either pre-operative or post-operative diagnosis of ovarian
tumor and received TVS between January I, 1996 and December 31, 1998 were included in the
study. Of 305 masses, 221 endometriomas of 164 patients were diagnosed histologically. The
efficacy of TVS was 84.9 per cent with a sensitivity of 92.3 per cent and specificity of 70.2 per cent.
LR+ and LR- were 3.1 and 0.1 respectively. The combination of TVS and pelvic examination
with either positive test had a higher sensitivity (98.8%) but lower specificity (26.6o/c). This
combination dramatically improved NPV (97.5%) and LR- (0.05), whereas, the combination
with both positive tests had a sensitivity of 78.1 per cent, and specificity of 81.5 per cent. LR+
and LR- were not different from those using TVS alone.
In conclusion, the study has shown the role of TVS in the diagnosis of ovarian endo-
metrioma. The combination of TVS and pelvic examination may be useful in ruling out the
disease. However, a further prospective study should be performed to confirm the efficacy of the
combination.
Keywords : Endometrioma, Diagnosis, Transvaginal Sonography, TVS, Pelvic Examination
