妇科影像报告和数据系统鉴别附件肿块良恶性的应用价值

Application value of gynaecological imaging report and data system in differentiating the benign and malignant adnexal tumors

目的探讨妇科影像报告和数据系统(GI-RADS)在附件肿块良恶性鉴别中的应用价值。方法回顾性分析在我院经手术病理确诊的附件肿块患者180例,恶性39例,良性141例,根据附件肿块的超声特征对其进行GI-RADS分类,以病理结果为金标准,绘制受试者工作特征(ROC)曲线分析其诊断附件肿块良恶性的截断值及其诊断效能。结果 180例附件肿块患者中GI-RADS 2类15例,均为良性;GI-RADS 3类112例,其中1例恶性;GI-RADS 4类25例,其中12例恶性;GI-RADS 5类28例,其中26例恶性。以GI-RADS 5类预测附件恶性肿块的敏感性、特异性、阳性预测值、阴性预测值及准确率分别为66.7%、98.6%、92.9%、91.4%、91.7%,曲线下面积为0.826;将GI-RADS 4、5类预测附件恶性肿块的敏感性、特异性、阳性预测值、阴性预测值及准确率分别为97.4%、89.4%、71.7%、99.2%、91.1%,曲线下面积为0.934;二者诊断敏感性、特异性、阳性预测值、阴性预测值、ROC曲线下面积比较差异均有统计学意义(均P<0.05)。结论 GI-RADS分类能够较好地鉴别诊断附件良恶性肿块,其中GI-RADS分类>3类为附件恶性肿块高风险,其诊断效能较好。

ObjectiveTo explore the application value of gynaecological imaging report and data system(GI-RADS)in the differential diagnosis of benign and malignant adnexal tumors.MethodsA total of 180 patients with adnexal tumors who confirmed by operation and pathology in our hospital were analyzed retrospectively.There were 39 cases of malignant adnexal tumors and 141 cases of benign adnexal tumors.They were classified by GI-RADS according to the ultrasonic characteristics of adnexal tumors.The diagnostic efficacy and cut-off value of ultrasound were calculated based on the gold standard of pathological results by receiver operating characteristic(ROC)curve.ResultsAmong 180 cases of adnexal tumors,15 cases were judged as GI-RADS 2 and none was malignant.There were 112 cases of GI-RADS 3 and 1 case of which was malignant.There were 25 cases of GI-RADS 4 and 12 cases of which were malignant.There were 28 cases of GI-RADS 5 and 26 cases of which were malignant. The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of GI-RADS 5 in predicting malignant tumors were 66.7%,98.6%,92.9%,91.4% and 91.7%,the area under the ROC curve(AUC)was 0.826.And these parameters of GI-RADS 4 and 5 in predicting malignant tumors were 97.4%,89.4%,71.7%,99.2% and 91.1%,AUC was 0.934,respectively.There were significant differences in sensitivity,specificity,positive predictive value,negative predictive value and AUC between the two methods(all P<0.05).ConclusionGI-RADS classification can be used to differentiate benign and malignant adnexal tumors with excellent diagnostic efficiency,and tumors with GI-RADS classification > 3 has high malignant risk.