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• W2019427610 abstract "Objective: To develop a formula to differentiate functional cysts (follicular and luteal cysts) from other adnexal masses, based on age, CA 125 value, ultrasound morphology and color Doppler findings in premenopausal non pregnant women.Design: Prospective study.Materials/Methods: Logistic regression analysis was performed to identify prognostic factors in 287 consecutive persistent (at least two menstrual cycles) adnexal masses. All these masses were preoperatively evaluated using B-mode transvaginal ultrasonography associated with color Doppler and power Doppler imaging evaluation and CA 125 plasma levels determination. In addition the overall agreement between the test result and the actual outcome was calculated using the K index.Results: As derived from logistic regression, after the sequential entering of at least ten variables into the analysis, the presence of following findings was considered to indicate the likelihood of functional cysts: (i) a unilocular anechoic smooth-walled cystic ovarian tumors without echogenic portion with value of CA 125 lower than 25 UI/mL (for follicular cysts); (ii) a fine trabecular jelly-like content or heterogeneous mass with hypoechoic content, with resistance index (RI) >0.4 and age lower than forty years (for luteal cysts). The diagnostic accuracy of different variables in differentiating functional cysts from other adnexal masses are shown in the table. In the differential diagnosis of follicular cysts, the K index of 0.74 suggests a good agreement between B-mode transvaginal ultrasonography and CA 125 and surgery. According to the logistic regression equation that was obtained, the probability of presence of follicular cyst varied between a minimum of 0% for patients with no risk factors to a maximum of 66% for patients with four significant variables (three B-mode findings and CA 125 <25 UI/mL). The probability of presence of luteal cyst varied between a minimum of 0% for patients with no risk factors to a maximum of 58% for patients with three variables (B-mode findings, resistance index >0.4 and age lower than forty years), with a K value of 0.58 that suggests a good agreement. Tabled 1Follicular cystsanechoic contentAbsence of septaAbsence ofvegetationsCA 125 < 25 UI/mLAll findingspositiveSensitivity (%)9386979079Specificity (%)8521226397PPV (%)4111122174NPV (%)9993989898Kappa value0.500.020.050.220.74Luteal cystsB-mode findings(trabecular oripoechoic content)B-mode findingsand RI>0.4B-mode findingsand RI>0.4 and age <40 yrsSensitivity (%)908369Specificity (%)869094PPV (%)414757NPV (%)999896Kappa value0.500.540.58 Open table in a new tab Conclusions: The power Doppler imaging (evaluation of peripheral vessel distribution) does not seem to increase the accuracy of transvaginal ultrasonography used alone. On the contrary, the addition of some other findings (such as age and CA 125 values, and RI values) can be useful to differentiate functional cysts from other adnexal masses. Objective: To develop a formula to differentiate functional cysts (follicular and luteal cysts) from other adnexal masses, based on age, CA 125 value, ultrasound morphology and color Doppler findings in premenopausal non pregnant women. Design: Prospective study. Materials/Methods: Logistic regression analysis was performed to identify prognostic factors in 287 consecutive persistent (at least two menstrual cycles) adnexal masses. All these masses were preoperatively evaluated using B-mode transvaginal ultrasonography associated with color Doppler and power Doppler imaging evaluation and CA 125 plasma levels determination. In addition the overall agreement between the test result and the actual outcome was calculated using the K index. Results: As derived from logistic regression, after the sequential entering of at least ten variables into the analysis, the presence of following findings was considered to indicate the likelihood of functional cysts: (i) a unilocular anechoic smooth-walled cystic ovarian tumors without echogenic portion with value of CA 125 lower than 25 UI/mL (for follicular cysts); (ii) a fine trabecular jelly-like content or heterogeneous mass with hypoechoic content, with resistance index (RI) >0.4 and age lower than forty years (for luteal cysts). The diagnostic accuracy of different variables in differentiating functional cysts from other adnexal masses are shown in the table. In the differential diagnosis of follicular cysts, the K index of 0.74 suggests a good agreement between B-mode transvaginal ultrasonography and CA 125 and surgery. According to the logistic regression equation that was obtained, the probability of presence of follicular cyst varied between a minimum of 0% for patients with no risk factors to a maximum of 66% for patients with four significant variables (three B-mode findings and CA 125 <25 UI/mL). The probability of presence of luteal cyst varied between a minimum of 0% for patients with no risk factors to a maximum of 58% for patients with three variables (B-mode findings, resistance index >0.4 and age lower than forty years), with a K value of 0.58 that suggests a good agreement. Tabled 1Follicular cystsanechoic contentAbsence of septaAbsence ofvegetationsCA 125 < 25 UI/mLAll findingspositiveSensitivity (%)9386979079Specificity (%)8521226397PPV (%)4111122174NPV (%)9993989898Kappa value0.500.020.050.220.74Luteal cystsB-mode findings(trabecular oripoechoic content)B-mode findingsand RI>0.4B-mode findingsand RI>0.4 and age <40 yrsSensitivity (%)908369Specificity (%)869094PPV (%)414757NPV (%)999896Kappa value0.500.540.58 Open table in a new tab Conclusions: The power Doppler imaging (evaluation of peripheral vessel distribution) does not seem to increase the accuracy of transvaginal ultrasonography used alone. On the contrary, the addition of some other findings (such as age and CA 125 values, and RI values) can be useful to differentiate functional cysts from other adnexal masses." @default.
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• W2019427610 title "Using a logistic model to differentiate ovarian functional cysts from other adnexal masses." @default.
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