Objective To evaluate the qualitative and quantitative diagnostic value of transvaginal contrast-enhanced ultrasonography for benign and malignant adnexal masses.Methods Forty-nine patients with adnexal masses detected by routine ultrasound examination at Wenzhou People's Hospital from January 2021 to December 2022 were included in this study.Initially,transvaginal two-dimensional ultrasound,two-dimensional ultrasound integrated with color Doppler,and contrast-enhanced ultrasonography were used to accurately classify the masses as benign or malignant.Using postoperative pathology as the gold standard,the qualitative diagnostic accuracy of various detection methods was compared.Subsequently,the receiver operating characteristic curve analysis was performed to assess the quantitative diagnostic accuracy of transvaginal contrast-enhanced ultrasonography-related parameters in distinguishing between benign and malignant adnexal masses.Results Among the 49 patients,10 were diagnosed with malignant tumors.The diagnostic accuracy of contrast-enhanced ultrasonography was 93.88％(46/49),with a sensitivity of 90.00％(9/10),a specifiicity of 94.87％(37/39),a positive predictive value of 81.82％(9/11),and a negative predictive value of 97.37％(37/38).The results of the diagnostic difference assessment(McNemar test)revealed that there was no signifiicant difference between two-dimensional ultrasound(x2=0.37,P=0.546),two-dimensional ultrasound combined with color Doppler(x2=0.17,P=0.683),and contrast-enhanced ultrasonography(x2=0.00,P=1.000),and the gold standard test results.The consistency assessment(Kappa test)revealed that the diagnostic results of contrast-enhanced ultrasonography exhibited the highest concordance with the gold standard,with a Kappa value of 0.82(P＜0.001).Furthermore,the receiver operating characteristic curve analysis indicated that the initial increase time,peak intensity,and mean transit time in contrast-enhanced ultrasonography demonstrated high quantitative diagnostic accuracy.The areas under the curve were 0.83,0.82,and 0.84,respectively,and the diagnostic cutoff values were 17.30 s,21.65 dB,and 92.60 seconds,respectively.Conclusion Contrast-enhanced ultrasonography exhibits diagnostic value in the differential diagnosis of benign and malignant adnexal masses,both qualitatively and quantitatively.This method can provide valuable insights for further treatment.
EndosonographyUltrasonography,doppler,colorAdnexal diseasesDiagnosis,differentialSensitivity and specificityROC curve
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