CT Diagnosis of Ovarian Endometrioma / 实用放射学杂志

ABSTRACT

Objective To improve the diagnostic accuracy of ovarian endometrioma and to discriminate it from other adnexal masses by analyzing its CT manifestations. Methods The CT images of 57 patients with 77 ovarian endometriomas proved by surgery and pathology were studied retrospectively.Results The cysts ranged in diameter from 2 to 14 cm with the mean size of 6.2 cm?5.1 cm. The margins of the cyst were sharp in 39 and ill defined in 38 endometriomas. Thin and thickened walls were found respectively in 40 and 37 of 77 endometriomas. Unilocular, bilocular and multilocular forms were seen respectively in 29(37.7%), 23(29.9%) and 25(32.5%) of 77 endometriomas. Gourd and sister forms were present respectively in 15 and 8 of 23 bilocular cysts, and sister loculi, outer son loculi, inner son loculi, and mixed forms in 10, 9, 1 and 5 of 25 multilocular endometriomas. The density of the cyst fluid varied from 11～65 HU with the mean of 28.5 HU. New hemorrhage inside cyst was found in 6 cysts. Slight or intermediate enhancement of the cyst wall of endometriomas in 42, and significant enhancement in 35 were demonstrated. 54 cysts, 13 cystadenomas with 18 lesions and 4 malignant tumors with 5 lesions were diagnosed by preoperatively by CT. The accurate rate of CT characterization was 71.4%. Conclusion The certain morphologic characteristics of the ovarian endometrioma can be showed by CT in higher extent. It is critical to familiar with these characteristics to improve the diagnostic accuracy, and to avoid misdiagnosis.