Comparison of diagnostic accuracy of transvaginal ultrasound with laparoscopy in the management of patients with adnexal masses.
OBJECTIVE
The aims of this study was (a) to compare the diagnostic accuracy of ultrasound examination with laparoscopic findings and both with the gold standard (histology) in the management of benign ovarian lesions, and (b) to assess the feasibility of laparoscopy in their diagnosis and management.


METHODS
Prospective, comparative study (Canadian Task Force Classification II-2). A total of 117 women 15-59 years old were examined at outpatient department and had transvaginal ultrasound assessment. Ninety-eight women (three postmenopausal) with 105 cystic ovarian lesions met inclusion criteria and underwent operative laparoscopy. Histology was performed in all cases.


RESULTS
Although laparoscopy showed an overall higher performance compared to transvaginal ultrasound, statistically significant difference was found only in the detection of endometriomas compared to ultrasound (P = 0.004 for sensitivity and P = 0.046 for specificity).


CONCLUSIONS
Laparoscopy exhibits higher diagnostic accuracy, especially in endometriomas, compared to transvaginal scan. Laparoscopic diagnosis appears to be safe and accurate. Conservative laparoscopic management of benign adnexal masses is safe and with low morbidity.
Theodoridis
Theodoros D
TD
1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece. theodtheo@yahoo.gr
Zepiridis
Leonidas
L
Mikos
Themistoklis
T
Grimbizis
Grigoris F
GF
Dinas
Konstantinos
K
Athanasiadis
Apostolos
A
Bontis
John N
JN
D000293:Adolescent; D000328:Adult; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D010048:Ovarian Cysts; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D018615:Ultrasonography, Doppler, Color / Q000379:methods* / Q000592:standards; D055815:Young Adult