| Summary: | Objective To assess whether the analysis of cyst content
using mean gray value (MGV) can discriminate ovarian
endometriomas from other unilocular ovarian cysts in
premenopausal women.
Methods Stored three-dimensional (3D) volumes from 54
unilocular ovarian cysts diagnosed in 50 premenopausal
women (mean age, 37 (range, 22–50) years) were
analyzed to calculate the MGV from cyst content. Cysts
with solid components or septations were excluded.
MGV was calculated in all cases with the Virtual
Organ Computer-aided AnaLysisTM technique. The Bmode
presumptive diagnosis based on the examiner’s
subjective impression was also recorded.
Results Sixteen of the cysts resolved spontaneously and
were given a final clinical diagnosis of hemorrhagic
functional cyst, while 38 cysts were removed surgically
(diagnosed histologically as seven simple cysts, three
hemorrhagic cysts, 20 endometriomas, five mucinous
cysts and three paraovarian cysts). B-mode diagnoses
were as follows: seven simple cysts, 18 hemorrhagic
cysts, 24 endometriomas, three mucinous cysts and two
paraovarian cysts. MGV was significantly higher in
ovarian endometrioma when compared with all other
kinds of cyst. The receiver–operating characteristics
curve showed that using an MGV cut-off ≥15.560
had a sensitivity of 85% and a specificity of 76.5%
for diagnosing ovarian endometrioma (area under the
curve, 0.831; 95% CI, 0.718–0.944). These figures were
similar to those for B-mode diagnosis (sensitivity, 90%;
specificity, 82%) (McNemar test, P = 1.000). Combining
B-mode and MGV gave a sensitivity of 80% and a
specificity of 91%.
Conclusion Cyst content MGV is higher in ovarian
endometrioma than it is in other unilocular ovarian cysts.
The diagnostic performance of MGV is similar to that of
the examiner’s subjective impression. The combination of
both criteria achieves the highest specificity
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