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© 2004 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 23:1193-1200 • 0278-4297

Role of Transvaginal Sonography in the Diagnosis of Peritoneal Inclusion Cysts

Stefano Guerriero, MD, Silvia Ajossa, MD, Valerio Mais, MD, Marco Angiolucci, MD, Anna Maria Paoletti, MD and Gian Benedetto Melis, MD

Department of Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy.

Address correspondence and reprint requests to Stefano Guerriero, MD, Department of Obstetrics and Gynecology, University of Cagliari, Ospedale San Giovanni di Dio, Via Ospedale 46, 09124 Cagliari, Italy. E-mail: gineca.sguerriero{at}tiscali.it.

Objective. The aim of this prospective study was to investigate the accuracy of B-mode transvaginal sonography alone and combined with color Doppler imaging and cancer antigen 125 (CA 125) plasma concentrations in differentiating peritoneal cysts from other adnexal masses. Methods. Between September 1999 and September 2003, 213 adnexal masses underwent transvaginal sonography combined with power Doppler evaluation. Plasma concentrations of CA 125 were measured before surgery. The sonographic suspicion of peritoneal cysts (the presence of a bizarre lump-shaped cyst with a thin wall and fine internal septations with or without an ovary suspended among adhesions) was then compared with the surgical diagnosis. The overall agreement between the sonographic test results and the surgical findings was calculated by the {kappa} index. The diagnostic value of each test was also evaluated with likelihood ratios (LRs). Results. Thirteen of 213 patients were found to have peritoneal cysts. Specificity and sensitivity of B-mode sonography for differentiating peritoneal cysts from other adnexal masses were 96% (95% confidence interval, 94%–97%) and 62% (95% confidence interval, 35%–83%), respectively. The value of the negative LR (0.40) indicated a good clinical test, whereas the positive LR (15) indicated an excellent test. Power Doppler imaging did not seem to increase the accuracy of B-mode transvaginal sonography ({kappa} = 0.51 and 0.52, respectively), nor did the association of CA 125 plasma concentration ({kappa} = 0.34). Conclusions. Transvaginal sonography alone is a useful method for detection of peritoneal cysts.

Key Words: cancer antigen 125 • pelvic inflammatory disease • peritoneal cysts • power Doppler imaging • transvaginal sonography

Abbreviations: CA 125, cancer antigen 125 • LR, likelihood ratio • RI, resistive index




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[Abstract] [Full Text] [PDF]


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Copyright © 2004 by the American Institute of Ultrasound in Medicine.