title: The utility of ultrasound elastography in differentiation of endometriomas and hemorrhagic ovarian cysts.
abstract: OBJECTIVE
  To investigate the feasibility of acoustic radiation force impulse imaging in differentiation of endometriomas and hemorrhagic ovarian cysts.
  
  
  METHODS
  We evaluated 84 ovarian cysts with high internal echogenicity diagnosed in 70 consecutive women. We excluded simple cysts and hemorrhagic cysts containing septations or mural nodules with detectable flow on Doppler ultrasonography. We obtained the elastographic shear wave velocity (SWV) value of the cysts that could be endometriomas or hemorrhagic ovarian cysts.
  
  
  RESULTS
  Among the 78 ovarian cysts in 70 women without any septation or mural nodule, there were 42 endometriomas and 36 hemorrhagic ovarian cysts. Analysis of median SWV values of the ovarian cysts showed that the endometriomas had considerably higher levels of stiffness compared to the hemorrhagic ovarian cysts [median SWV 4.20 ± 0.42 vs 2.54 ± 1.04 m/s, p < 0.001]. A SWV cutoff value greater than 3.81 m/s yielded sensitivity and specificity values of 82.1 and 79.2 % respectively, for differentiation of endometriomas from hemorrhagic ovarian cysts.
  
  
  CONCLUSIONS
  Sonoelastography is a novel imaging technique that enables us to evaluate the stiffness of adnexal lesions. The accurate discrimination of endometriomas and hemorrhagic ovarian cysts is important for avoiding unnecessary surgical procedures. ARFI imaging has a high sensitivity and specificity for distinguishing endometrioma from hemorrhagic ovarian cysts.
authors.affiliation: Department of Radiology, Dursun Odabas Medical Center, Yuzuncuyil University, 65080, Van, Turkey. baturabdussamet@gmail.com.
authors.forename: Abdussamet
authors.initials: A
authors.lastname: Batur
authors.affiliation: Department of Radiology, Dursun Odabas Medical Center, Yuzuncuyil University, 65080, Van, Turkey.
authors.forename: Alpaslan
authors.initials: A
authors.lastname: Yavuz
authors.affiliation: Department of Radiology, Dursun Odabas Medical Center, Yuzuncuyil University, 65080, Van, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Ozgokce
authors.affiliation: Department of Radiology, Dursun Odabas Medical Center, Yuzuncuyil University, 65080, Van, Turkey.
authors.forename: Aydın
authors.initials: A
authors.lastname: Bora
authors.affiliation: Department of Radiology, Dursun Odabas Medical Center, Yuzuncuyil University, 65080, Van, Turkey.
authors.forename: Mehmet Deniz
authors.initials: MD
authors.lastname: Bulut
authors.affiliation: Department of Radiology, Dursun Odabas Medical Center, Yuzuncuyil University, 65080, Van, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Arslan
authors.affiliation: Department of Radiology, Dursun Odabas Medical Center, Yuzuncuyil University, 65080, Van, Turkey.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Alpaslan
mesh_terms: D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004715:Endometriosis / Q000000981:diagnostic imaging*; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D010048:Ovarian Cysts / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012372:ROC Curve; D018608:Ultrasonography, Doppler / Q000379:methods*; D055815:Young Adult
keywords: ARFI imaging; Elastography; Endometrioma; Hemorrhagic ovarian cyst