The characterization of common ovarian cysts in premenopausal women

Objectives The evaluation of the predictive value of transvaginal ultrasoun d in the assessment of benign adnexal pathology in premenopausal women, bas ed on the recognition of characteristic morphologic pattens particular to e ndometriotic and dermoid ovarian cysts. Methods This was a prospective study. All premenopausal women undergoing su rgery for a suspected ovarian cyst underwent a transvaginal ultrasound exam ination in the week prior to surgery. Between June 1997 and January 2000, 1 32 women underwent surgery for a suspected ovarian endometrioma or dermoid cyst. The endpoints were either the direct visualization of the cyst wall a nd contents at surgery, or the histologic evaluation of removed tissues. Results Of 83 suspected endometriomas (11 bilateral), 80 were confirmed at surgery and of 68 suspected benign cystic teratomas (eight bilateral), 66 w ere confirmed by histology. The positive predictive value of transvaginal u ltrasonography for the diagnosis of endometrioma and dermoid cysts tvas 96. 4% and 97.1%, respectively. The false positive rates were 3.8% and 3.0%, re spectively. There were no malignancies in either group. Conclusions Based on the recognition of characteristic ultrasound patterns alone, the positive predictive value of transvaginal ultrasonography for th e diagnosis of these common, benign cysts in premenopausal women is very hi gh and can he used reliably to select women for appropriate surgery.