The role of transvaginal ultrasonography combined with color velocity imaging and pulsed Doppler in the diagnosis of endometrioma

Alcázar, Juan Luis; Laparte, C.; Jurado, M.; López-Garcı́a, Guillermo

doi:10.1016/s0015-0282(97)80074-x

Cited by 125 publications

(70 citation statements)

References 19 publications

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“…10 The presence of ascites was also recorded. Pattern recognition analysis was used for adnexal masses highly suggestive of given diseases such as endometrioma, 11 mature teratoma, 12 hydrosalpinx, 13 peritoneal cyst, 14 hemorrhagic cyst, 15 follicular cyst, 16 paraovarian cyst, 17 tubo-ovarian abscess, 18 simple cyst, 19 and cystadenofibroma. 20 After the morphologic evaluation was performed, the color Doppler gate was activated to identify vascular color signals within the tumor.…”

Section: Methodsmentioning

confidence: 99%

Gynecologic Imaging Reporting and Data System

Amor¹,

Vaccaro²,

Alcázar

et al. 2009

Journal of Ultrasound in Medicine

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Objective. The purpose of this study was to describe a new reporting system called the Gynecologic Imaging Reporting and Data System (GI-RADS) for reporting findings in adnexal masses based on transvaginal sonography. Methods. A total of 171 women (mean age, 39 years; range, 16-77 years) suspected of having an adnexal mass were evaluated by transvaginal sonography before treatment. Pattern recognition analysis and color Doppler blood flow location were used for determining the presumptive diagnosis. Then the GI-RADS was used, with the following classifications: GI-RADS 1, definitively benign; GI-RADS 2, very probably benign; GI-RADS 3, probably benign; GI-RADS 4, probably malignant; and GI-RADS 5, very probably malignant. Patients with GI-RADS 1 and 2 tumors were treated expectantly. All GI-RADS 3, 4, and 5 tumors were removed surgically, and a definitive histologic diagnosis was obtained. The GI-RADS classification was compared with final histologic diagnosis. Results. A total of 187 masses were evaluated. The prevalence rate for malignant tumors was 13.4%. Overall GI-RADS classification rates were as follows: GI-RADS 1, 4 cases (2.1%); GI-RADS 2, 52 cases (27.8%); GI-RADS 3, 90 cases (48.1%); GI-RADS 4, 13 cases (7%); and GI-RADS 5, 28 cases (15%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 92%, 97%, 85%, 99%, and 96%, respectively. Conclusions. Our proposed reporting system showed good diagnostic performance. It is simple and could facilitate communication between sonographers/ sonologists and clinicians. Key words: adnexal mass; reporting system; sonography. ransvaginal sonography (TVS) has become the first-step imaging technique for characterizing adnexal masses. When used by experienced examiners, this technique achieves high sensitivity for identifying ovarian cancer, and it has been shown to be useful for selecting the best surgical approach. [1][2][3] However, despite the tremendous progress in the diagnostic capability of TVS, a large multicenter study reported that the false-positive rate could be as high as 24%. 4 One explanation for this high false-positive rate may be operator experience, as has been shown in a recent randomized trial.5 Another reason could be a problem in the transmission of information about findings from the sonologist or sonographer to the clinician who makes final decision. As a matter of fact, reports describing sonographic findings are sometimes confusing.

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Section: Methodsmentioning

confidence: 99%

Gynecologic Imaging Reporting and Data System

Amor¹,

Vaccaro²,

Alcázar

et al. 2009

Journal of Ultrasound in Medicine

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“…In particular, an ovarian endometrioma was identified by the presence of a cystic ovarian mass characterised by persistent circular, homogeneous, hypoechoic ''tissue'' without papillary proliferations that had a clear demarcation from the ovarian parenchyma [9][10][11][12] and a diameter of more than 2 cm. Ovarian nodules were defined lesions smaller than 20 mm in mean diameter.…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up after laparoscopic treatment for endometriosis: multivariate analysis of predictive factors for recurrence of endometriotic lesions and pain

Coccia

Rizzello

Palagiano

et al. 2011

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Color flow mapping showed only pericystic flow at the level of the ovarian hilus (Alcazar et al, 1997). The solid pattern like this has been found in 4.9% of endometriomas (Pascual et al, 2000).…”

Section: Diagnostic Indices Of Simple Rules In D I F F E Re N T I a Tmentioning

confidence: 55%

Sonographic Pattern Recognition of Endometriomas Mimicking Ovarian Cancer

Saeng-anan

Pantasri²,

Neeyalavira³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: To assess the accuracy of ultrasound in differentiating endometrioma from ovarian cancer and to describe pattern recognition for atypical endometriomas mimicking ovarian cancers. Materials and Methods: Patients scheduled for elective surgery for adnexal masses were sonographically evaluated for endometrioma within 24 hours of surgery. All examinations were performed by the same experienced sonographer, who had no any information of the patients, to differentiate between endometriomas and non-endometriomas using a simple rule (classic ground-glass appearance) and subjective impression (pattern recognition). The final diagnosis as a gold standard relied on either pathological or post-operative findings. Results: Of 638 patients available for analysis, 146 were proven to be endometriomas. Of them, the simple rule and subjective impression could sonographically detect endometriomas with sensitivities of 64.4% (94/146) and 89.7% (131/146), respectively. Of 52 endometriomas with false negative tests by the simple rule, 13 were predicted as benign masses and 39 were mistaken for malignancy. Solid masses and papillary projections were the most common forms mimicking ovarian cancer, consisting of 38.5% of the missed diagnoses. However, with pattern recognition (subjective impression), 32 from 39 cases mimicking ovarian cancer were correctly predicted for endometriomas. All endometriomas subjectively predicted for ovarian malignancy were associated with high vascularization in the solid masses. Conclusions: Pattern recognition of endometriomas by subjective assessment had a higher sensitivity than the simple rule in characterization of endometriomas. Most endometriomas mimicking ovarian malignancy could be correctly predicted by subjective impression based on familiarity of pattern recognition.

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The role of transvaginal ultrasonography combined with color velocity imaging and pulsed Doppler in the diagnosis of endometrioma

Cited by 125 publications

References 19 publications

Gynecologic Imaging Reporting and Data System

Gynecologic Imaging Reporting and Data System

Long-term follow-up after laparoscopic treatment for endometriosis: multivariate analysis of predictive factors for recurrence of endometriotic lesions and pain

Sonographic Pattern Recognition of Endometriomas Mimicking Ovarian Cancer

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