TRANSVAGINAL SONOGRAPHIC EVALUATION OF MULTIPLE PERIPHERALLY DISTRIBUTED ECHOGENIC FOCI OF THE OVARY - PREVALENCE AND HISTOLOGIC CORRELATION

OBJECTIVE. Our aim was to determine the prevalence, histopathologic co rrelation, and clinical significance of multiple peripherally distribu ted echogenic foci seen within ovaries on transvaginal sonography. SUB JECTS AND METHODS. Transvaginal sonograms of 264 ovaries in 135 patien ts were prospectively analyzed for the presence of peripheral echogeni c foci that were then characterized as linear, punctate, or globular. Previous examinations, when available, were reviewed for this sonograp hic feature, and the time interval between studies was recorded as a m easure of stability. Sonograms were correlated with available surgical specimens in six patients, five of whom underwent hysterectomy and bi lateral oophorectomy and the remaining patient who underwent laparosco pic ovarian wedge biopsy. RESULTS. Multiple peripheral echogenic foci were common and were found in 66 patients (49%) and 97 ovaries (37%). The punctate pattern was seen in 63 (95%) of 66 patients. The linear a nd globular patterns were present in only three and four patients, res pectively. These echogenic foci were found on previous examinations in 18 patients. No suspicious sonographic features were seen in the ovar ies of any of these patients. Histologic evaluation revealed multiple superficial epithelial inclusion cysts and associated psammomatous cal cifications in all five patients who underwent bilateral oophorectomy An additional finding in one of these patients was extensive endosalpi ngiosis. CONCLUSION. Multiple peripheral echogenic foci involving the ovaries is a common incidental finding on routine transvaginal sonogra phy of the pelvis. Our data suggest that this sonographic finding repr esents psammomatous calcifications associated with superficial epithel ial inclusion cysts.