Value of MRI-Based Ovarian-Adnexal Reporting and Data System for the Diagnosis of Adnexal Masses
Objective To assess the value of the MRI-based ovarian-adnexal reporting and data system(O-RADS MRI)for the diagnosis of adnexal masses.Methods A total of 407 patients who underwent dynamic con-trast enhancement(DCE)-MRI and pathological examination(gold standard)at the Department of Radiology,Central Hospital of Wuhan between May 2017 and December 2022 were enrolled in this study.Two radiologists performed the O-RADS MRI scoring of adnexal masses according to MRI features and calculated the malignancy rate of adnexal masses by O-RADS MRI score,enhancement type,and mass type.Moreover,receiver operating characteristic curves were established to further evaluate the diagnostic values of O-RADS MRI score,enhance-ment type,and mass type for adnexal masses.Results A total of 502 adnexal masses were identified in the 407 patients enrolled in this study,including 364 benign masses and 138 malignant masses(including junctional masses).Radiologist 1 reported the malignancy rates of 0,0,5.4％,80.0％,and 89.7％and radiologist 2 reported the malignancy rates of 0,0,5.8％,86.2％,and 83.0％for the adnexal masses with the O-RADS MRI scores of 1-5,respectively.With O-RADS MRI ≥4 indicating malignant masses,the sensitivity,specifici-ty,accuracy,positive predictive value,negative predictive value,false negative rate,and false positive rate were 94.2％,93.6％,93.8％,84.9％,97.7％,2.3％,and 15.1％for radiologist 1 and 93.4％,93.6％,93.6％,85.4％,97.4％,3.6％,and 14.6％for radiologist 2,respectively.The malignancy rates of the adnexal masses presenting no enhancement,cystic wall enhancement,type Ⅰ curve,type Ⅱ curve,and type Ⅲ curve were 0,1.3％,5.7％,81.2％,and 89.0％as reported by radiologist 1 and 0,1.2％,11.3％,87.6％,and 80.0％as reported by radiologist 2,respectively.The malignancy rates of the adnexal masses that were cystic lesions,cystic segregated lesions,solid lesions,cystic solid lesions,and cystic solid segregated lesions were 0,7.1％,38.7％,79.1％,and 89.8％as reported by radiologist 1 and 0,8.1％,37.8％,72.4％,and 89.6％as reported by radiologist 2,respectively.With type Ⅱ and type Ⅲ curves as the criteria for malignancy,the sensitivity of radiologists 1 and 2 was lower for cystic segregated lesions,both at 50.0％.For the masses containing solid components,radiologists 1 and 2 demonstrated low specificity,which was 57.7％and 56.5％,respectively.False-positive masses contained solid components and were mostly fibroad-enomas or adnexal leiomyomas,while false-negative masses were mostly junctional cystadenomas with no or few solid components.Conclusions The O-RADS MRI risk stratification has a high diagnostic value for adnexal mas-ses.Further evaluation and refinement are needed to reduce the false-positive rate.
ovarian-adnexal reporting and data systemMRIadnexal massdiagnostic value
万方数据
维普
