Transvaginal sonographic appearance of peritoneal pseudocysts

Savelli, L.; Iaco, Pierandrea De; Ghi, T.; Bovicelli, Luciano; Rosati, F.; Cacciatore, Bruno

doi:10.1002/uog.986

Cited by 35 publications

(28 citation statements)

References 19 publications

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“…Only a few retrospective studies and case series about the role of sonography in the diagnosis of this kind of cyst are reported in the literature. [7][8][9][10][11] Our study suggests that this kind of cyst shows a variety of imaging appearances, which can be confused with various adnexal masses of the female pelvis. In fact, the low sensitivity obtained in our study shows that a hydrosalpinx, a hemorrhagic cyst, a mucinous cystadenoma, a dermoid cyst, a serous cystadenoma, and other kinds of cysts 10 can simulate the presence of a peritoneal cyst.…”

Section: Guerriero Et Almentioning

confidence: 78%

“…5 Patients usually have chronic abdominal or pelvic pain, and sonography can be used for the diagnosis, although these kinds of cysts, if not well recognized, can be suspected to be ovarian cancer. 6 For these reasons, several authors [7][8][9][10][11] retrospectively investigated the sonographic appearance of peritoneal pseudocysts. Among the findings observed in cases of peritoneal pseudocysts, the presence of a bizarre lump-shaped cyst with a thin wall and fine internal septations is considered the most suggestive.…”

mentioning

confidence: 99%

“…10 The lump shape is due to the pres-ence of adhesions filled by fluid and connecting the serosal surfaces of the surrounding organs. 11 In some cases, the presence of an ovary suspended among adhesions can be also observed. 3,10 To our knowledge, transvaginal sonography has never been evaluated prospectively in the diagnosis of this kind of pelvic disease.…”

mentioning

confidence: 99%

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Role of Transvaginal Sonography in the Diagnosis of Peritoneal Inclusion Cysts

Guerriero

Ajossa

Mais

et al. 2004

Journal of Ultrasound in Medicine

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Objective. The aim of this prospective study was to investigate the accuracy of B-mode transvaginal sonography alone and combined with color Doppler imaging and cancer antigen 125 (CA 125) plasma concentrations in differentiating peritoneal cysts from other adnexal masses. Methods. Between September 1999 and September 2003, 213 adnexal masses underwent transvaginal sonography combined with power Doppler evaluation. Plasma concentrations of CA 125 were measured before surgery. The sonographic suspicion of peritoneal cysts (the presence of a bizarre lump-shaped cyst with a thin wall and fine internal septations with or without an ovary suspended among adhesions) was then compared with the surgical diagnosis. The overall agreement between the sonographic test results and the surgical findings was calculated by the κ index. The diagnostic value of each test was also evaluated with likelihood ratios (LRs). Results. Thirteen of 213 patients were found to have peritoneal cysts. Specificity and sensitivity of B-mode sonography for differentiating peritoneal cysts from other adnexal masses were 96% (95% confidence interval, 94%-97%) and 62% (95% confidence interval, 35%-83%), respectively. The value of the negative LR (0.40) indicated a good clinical test, whereas the positive LR (15) indicated an excellent test. Power Doppler imaging did not seem to increase the accuracy of B-mode transvaginal sonography (κ = 0.51 and 0.52, respectively), nor did the association of CA 125 plasma concentration (κ = 0.34). Conclusions. Transvaginal sonography alone is a useful method for detection of peritoneal cysts.

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Section: Guerriero Et Almentioning

confidence: 78%

mentioning

confidence: 99%

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Role of Transvaginal Sonography in the Diagnosis of Peritoneal Inclusion Cysts

Guerriero

Ajossa

Mais

et al. 2004

Journal of Ultrasound in Medicine

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“…However, when present, pelvic adhesions may be identified as fine hyperechoic strands that are frequently seen to sway when pressure is applied with the vaginal probe. 9 Guerriero et al 19 evaluated TVS for the diagnosis of pelvic adhesions. They evaluated clinical factors alongside an ultrasound-based assessment of ovarian mobility, using the distance from the ovary to the probe and blurring of the margins of the ovary in women with a variety of clinical symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Also, in women with endometriosis or pelvic adhesions, the ovary is frequently found to be adherent to the pelvic sidewall or the uterus at the time of laparoscopy. Loculated peritoneal fluid can be identified by TVS 9 and may be an indirect marker of pelvic pathology. The aim of this study was to see if this information could be obtained using TVS, and in combination with hard markers used to improve diagnostic confidence.…”

Section: Methodsmentioning

confidence: 99%

The use of ultrasound‐based ‘soft markers’ for the prediction of pelvic pathology in women with chronic pelvic pain—can we reduce the need for laparoscopy?

Okaro

Condous

Khalid

et al. 2006

BJOG

139

125

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Objective To assess the accuracy of new transvaginal ultrasoundscan-based markers and to compare them to conventional ultrasound methods used in the detection of common pelvic pathology in women with chronic pelvic pain (CPP).Design A prospective observational study. Setting Teaching hospital.Population A total of 120 consecutive women with CPP undergoing transvaginal ultrasonography before either diagnostic or operative laparoscopy.Methods Anatomical abnormalities, e.g. endometrioma or hydrosalpinx (hard markers), were documented. The woman was then assessed for the presence or absence of 'soft markers' (reduced ovarian mobility and site-specific pelvic tenderness).Main outcome measure Presence or absence of pelvic pathology noted during laparoscopy.Results Seventy women had pelvic pathology, of whom 51 had endometriosis alone, 7 both endometriosis and pelvic adhesions, 6 pelvic adhesions, 1 hydrosalpinx with endometriosis and 5 hydrosalpinx and pelvic adhesions. The likelihood ratio for the hard markers was infinity (specificity was 100%), for the soft makers 1.9 (95% CI 1.2-3.1) and for a 'normal' ultrasound 0.18 (0.09-0.34). The pre-test probability of pelvic disease in our population of women with CPP was 58%, and this probability of disease was raised to 100% with the presence of hard markers and to 73% with the presence of soft markers. The pre-test probability of 58% fell to 20% when ultrasound finding was found to be normal. ConclusionThis new approach improves the detection and exclusion of significant pathology in women with CPP and may lead to a reduction in the number of unnecessary laparoscopies carried out on women with CPP.

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