超声国际卵巢肿瘤研究组简单法则与妇科影像报告与数据系统分类诊断卵巢肿瘤的比较

Comparison of ultrasound IOTA simple rules and GI-RADS ultrasonographic stratification in diagnosis of ovarian neoplasms

目的比较超声国际卵巢肿瘤研究组(IOTA)简单法则与妇科影像报告与数据系统(GI-RADS)诊断卵巢肿瘤的价值。方法由高年资医师运用IOTA简单法则对463例卵巢肿瘤进行分类,将诊断为良性和恶性的卵巢肿瘤纳入研究。然后,由低年资和高年资医师在互不知道检查结果的情况下分别运用IOTA简单法则和GI-RADS分类进行诊断,定义低年资医师采用IOTA简单法则诊断为A1组,高年资医师采用IOTA简单法则诊断为B1组,低年资医师采用GI-RADS诊断为A2组,高年资医师采用GI-RADS诊断为B2组,比较两种方法的诊断效能。结果 463例病例中,高年资医师IOTA确认良性及恶性的卵巢肿瘤共411例(411/463,88.77%),不能确定性质的52例(52/463,11.23%)。A2与B2组间、A1与A2组间特异度、阳性预测值和诊断正确率差异均有统计学意义(P均<0.05),敏感度与阴性预测值差异无统计学意义(P均>0.05)。诊断效能各指标在A1与B1组间、B1与B2组间差异均无统计学意义(P均>0.05)。结论 IOTA简单法则和GI-RADS分类对卵巢良恶性肿瘤的诊断效能相当且均较高。IOTA简单法则不存在经验依赖性,但不适合全部卵巢肿瘤的评价。

Objective To compare the value of ultrasound International Ovarian of Tumor Analysis（IOTA）simple rules and gynecologic imaging reporting and data system（GI-RADS）ultrasonographic stratification in the diagnosis of adnexal masses.Methods A total of 463 patients with adnexal masses were classified according to IOTA simple rules by senior doctor.The benign and malignant masses were enrolled in the study.Then the masses were judged according to GI-RADS classification and IOTA simple rules by senior and junior doctors.And junior doctorn in diagnosis of adnexal masses with IOTA was group A1,senior doctor in diagnosis of adnexal masses with IOTA was group B1,junior doctor in diagnosis of adnexal masses with GI-RADS was A2,senior doctor in diagnosis of adnexal masses with GI-RADS was B2.The efficacy of the two methods were compared.Results Among the 463 cases,there were 411cases（411/463,88.77%）of benign mass and malignant mass by IOTA and 52cases（52/463,11.23%）of uncertain mass.The specificity,positive predictive value,diagnostic accuracy had statistical differences between groups A2 and B2,A1 and A2（all P〈0.05）,and sensitivity and negative predictive value had no statistical differences（all P〉0.05）.Diagnostic efficacy index had no statistial significance between group A1 and B1,B1 and B2（all P〉0.05）.Conclusion The diagnostic efficacy of IOTA simple rules and GI-RADS is high and similar in diagnosis of benign and malignant adnexal masse.IOTA simple rules do not depend on experience,but they are not suitable for the diagnosis of all adnexal masses.