Value of O-RADS ultrasound risk stratification plus contrast-enhanced ultrasound to the diagnosis of ovarian-adnexal masses
Objective To explore the value of O-RADS ultrasound risk stratification combined with contrast-enhanced ultrasound(CEUS)to the differential diagnosis of benign and malignant ovarian-adnexal masses.Methods Forty-four patients with ovarian-adnexal masses underwent routine transabdominal or transvaginal ultrasound and CEUS in Henan Provincial People's Hospital from November 2021 to April 2023.The ultrasound data of the masses were analyzed by three methods as O-RADS ultrasound risk stratification(the masses were evaluated by two senior sonographers,and the final results were determined after discussion when their results were inconsistent),CEUS(with time-intensity curve analysis,the benign and malignant masses were determined according to the enhancement characteristics of the masses),and combined evaluation of O-RADS ultrasound risk stratification and CEUS(O-RADS ultrasound risk stratifications of the masses were adjusted according to the evaluation results of CEUS).Surgical or puncture biopsy histopathological examination were performed within 3 months after CEUS.Kappa test was used to evaluate the consistency of the results of O-RADS ultrasound risk stratification by two sonographers.The ROC curves were plotted to evaluate the efficiencies of O-R ADS ultrasound risk stratification,CEUS and their combination on the diagnosis of malignant ovarian-adnexal masses.Results In 44 patients(51 masses),there were 36 benign masses and 15 malignant(including borderline)masses.The final O-R ADS ultrasound risk stratification results of 51 masses were no grade 1 mass,5 grade 2 masses,5 grade 3 masses,22 grade 4 masses,and 19 grade 5 masses.The consistency of two sonographers in evaluating the O-RADS ultrasound risk stratification of masses was high(Kappa=0.878,P＜0.001).CEUS found 34 benign masses and 17 malignant masses.After the combined evaluation of O-RADS ultrasound risk stratification and CEUS,33 masses remained the same O-RADS ultrasound risk stratification,1 mass was upgraded from grade 2 to grade 3,4 masses were upgraded from grade 3 to grade 4,3 masses were downgraded from grade 4 to grade 3,3 masses were upgraded from grade 4 to grade 5,and 7 masses were downgraded from grade 5 to grade 4.The AUCs of O-RADS ultrasound risk stratification,CEUS and their combination in the diagnosis of malignant ovarian-adnexal masses were 0.768(95％CI:0.628-0.874,P＜0.001),0.831(95％CI:0.699-0.921,P＜0.001)and 0.853(95％CI:0.726-0.936,P＜0.001),the sensitivities were 73.33％,80.00％and 86.67％,the specificities were 77.78％,86.11％and 91.67％,and the accuracy rates were 76.47％,84.31％and 90.20％,respectively.The AUC of O-RADS ultrasound risk stratification combined with CEUS in the diagnosis of malignant ovarian-adnexal masses was higher than that of O-RADS ultrasound risk stratification(Z=2.234,P=0.025),and showed no significant difference compared with CEUS(Z=1.585,P=0.113).There was no significant difference in the AUC between O-RADS ultrasound risk stratification and CEUS(Z=1.000,P=0.317).Conclusion The efficiency of O-RADS ultrasound risk stratification combined with CEUS on the differential diagnosis of benign and malignant ovarian-adnexal masses is higher than that of either of them two.
NETL
NSTL
万方数据
