TRANSVAGINAL ULTRASONOGRAPHY COMBINED WITH CA-125 PLASMA-LEVELS IN THE DIAGNOSIS OF ENDOMETRIOMA

Objective: To assess the role of transvaginal ultrasonography combined with CA-125 plasma levels in the diagnosis of endometrioma. Design: P rospective study with pathological confirmation of the diagnosis. Sett ing: Department of Obstetrics and Gynecology of the University of Cagl iari, Italy. Patients: One hundred one consecutive premenopausal nonpr egnant women submitted to laparoscopy or laparotomy, from November 199 3 to October 1994, because of the presence of an adnexal mass. Interve ntions: Within 2 days before surgery all patients underwent transvagin al ultrasonography and evaluation of CA-125 plasma levels. The ultraso nographic impression and the CA-125 value were then compared with the histopathological diagnosis. Main Outcome Measure: The overall agreeme nt between the test result and the actual outcome was calculated using the kappa index for the transvaginal ultrasonography used alone and f or the combination of transvaginal ultrasonography and CA-125 values, for each chosen cutoff and range. Results: Transvaginal ultrasonograph y has a strong agreement between test and surgery (kappa value 0.76) w hereas the combined use of the two methods is associated with a lower kappa index, ranging from 0.40 to 0.69. Conclusion: Transvaginal ultra sonography used alone has a better predictive capacity in differentiat ing endometrioma from other adnexal masses than combined methods.