Ultrasound is one way to confirm the diagnosis of chocolate cysts, but it is not the only way. This is because ultrasound is an important method for diagnosing ovarian ectopic cysts, and intravesical metastases. It can determine the size of the ectopic cyst, including the shape, with a diagnostic and sensitivity of 96% or more. So ultrasound will exist with 96% accuracy to be able to determine if it is a chocolate cyst. And when the examination is performed it will usually show a cyst that is round or oval in shape and adheres to the surrounding, especially the uterus. The cyst wall is thick and rough and there are small flocculent light spots inside the cyst. Since the echogram of the cyst is not specific, it is not possible to rely on the ultrasound alone to confirm the diagnosis in detail. CT scan or MRI of the pelvis can be performed for the diagnosis of pelvic ectasia, because it is more expensive and usually ultrasound is preferred. If you want to be 100% sure, laparoscopic exploration followed by pathological tests is necessary, which is 100% accurate.