Volpi E, De Grandis T, Zuccaro G, La Vista A, Sismondi P
Institute of Obstetrics and Gynecology, Torino, Italy.
J Clin Ultrasound. 1995 Mar-Apr;23(3):163-7. doi: 10.1002/jcu.1870230303.
Endometriosis is a common cause of pelvic pain and infertility in young women. Transvaginal sonography is major means for diagnosing ovarian In our study, we scanned 60 patients with endometriomata who underwent laparotomy or laparoscopy. We compared preoperative ultrasonographic diagnosis with histological reports. The sonographic criteria for the diagnosis of endometriomata were (1) cystic structure with low, homogeneous echogenicity and (2) thick cystic wall with regular margins. In 50 patients, sonography suggested an endometrioma. In 47 cases, the diagnosis was correct. The false-positive cases were all caused by cystic teratomas with a homogeneous sonographic pattern. Ten false-negative cases were diagnosed by ultra-sonography as functional ovarian cysts (5), teratomas (3), and benign ovarian cystoma (1). Only 1 case of a 5-mm endometrioma was demonstrated by laparoscopy but not by TVS. The sensitivity of TVS for diagnosing endometriomata was 82.4% and specificity 97.7%; the positive and negative predictive values were 94% and 92.8%, respectively. The diagnostic accuracy of TVS was 93%. In our experience, TVS is a very specific means for diagnosing endometriomata when the typical pattern is detected; however, the sensitivity of the technique needs to be improved.
子宫内膜异位症是年轻女性盆腔疼痛和不孕的常见原因。经阴道超声检查是诊断卵巢疾病的主要手段。在我们的研究中，我们对60例行剖腹手术或腹腔镜检查的子宫内膜瘤患者进行了扫描。我们将术前超声诊断与组织学报告进行了比较。诊断子宫内膜瘤的超声标准为：（1）具有低回声、均匀回声的囊性结构；（2）囊壁增厚，边缘规则。50例患者超声检查提示为子宫内膜瘤。47例诊断正确。假阳性病例均由具有均匀超声图像的囊性畸胎瘤引起。10例假阴性病例经超声检查诊断为功能性卵巢囊肿（5例）、畸胎瘤（3例）和良性卵巢囊腺瘤（1例）。腹腔镜检查发现1例5毫米的子宫内膜瘤，但经阴道超声未显示。经阴道超声诊断子宫内膜瘤的敏感性为82.4%，特异性为97.7%；阳性和阴性预测值分别为94%和92.8%。经阴道超声的诊断准确性为93%。根据我们的经验，当检测到典型图像时，经阴道超声是诊断子宫内膜瘤的一种非常特异的手段；然而，该技术的敏感性需要提高。
