THE DIAGNOSIS OF ENDOMETRIOMAS USING COLOR DOPPLER ENERGY IMAGING

We studied the role of colour Doppler energy (CDE) (or power Doppler) imaging in the differentiation between endometriomas and other adnexal masses in premenopausal non-pregnant women, A total of 170 consecutiv e patients with persistent adnexal masses was submitted to B-mode tran svaginal ultrasonography associated with CDE imaging evaluation. Plasm a concentrations of CA125 were measured before surgery. Using CDE imag ing evaluation of vessel distribution, the occurrence of one of the fo llowing findings was considered to indicate the likely presence of end ometrioma: (i) a round-shaped homogeneous hypoechoic 'tissue' of low-l evel echoes without papillary proliferations associated with 'poor' va scularization; (ii) a round-shaped homogeneous hypoechoic 'tissue' of low-level echoes with an echogenic portion in which no flow was detect ed. The overall agreement between the test result and the actual outco me was calculated using the k index. The CDE imaging evaluation was mo re accurate in the diagnosis of endometriomas compared with B-mode ult rasonography alone (k = 0.88 and 0.80 respectively). According to the logistic regression equation obtained, the probability of the presence of endometrioma varied between a minimum of 1.4% for patients with no risk factors to a maximum of 95.6% for patients with two risk factors (CDE result and value of CA125 >25 IU/ml).