卵巢-附件影像报告和数据系统、妇科影像报告和数据系统及简单规则在附件肿物良恶性诊断中的价值

Value of ovarian-adnexal imaging reporting and data system,gynecological imaging reporting and data system and simple rules in diagnosis of benign and malignant adnexal tumors

目的本研究旨在比较卵巢-附件影像报告和数据系统(O-RADS)、妇科影像报告和数据系统(GIRADS)、国际肿瘤小组简单规则(IOTA SR)三种分类系统在超声诊断附件肿物良恶性中的应用价值。方法回顾性分析2018年1月至2020年12月在郑州大学第二附属医院手术的附件肿物患者255例,所有患者均行经阴道或经腹部超声检查,术后由病理诊断。由两位超声住院医生(经验<5年)双盲评估所有附件肿物,应用O-RADS、GI-RADS、IOTA SR对附件肿物评估,以病理结果为金标准,比较O-RADS、GI-RADS、IOTA SR对附件肿物的诊断效能。结果255例患者(年龄14~85岁)中,良性203例,恶性52例。敏感度方面,O-RADS=GI-RADS>IOTA SR;准确率和特异度方面,O-RADS>GI-RADS>IOTA SR。O-RADS、GIRADS和IOTA SR诊断附件恶性肿瘤的差异具有统计学意义(P<0.001、P=0.008、P=0.049)。不同的低年资超声医师对O-RADS、GI-RADS、IOTA SR的Kappa系数为0.959、0.941、0.901,一致性较优。结论O-RADS、GI-RADS和IOTA SR在附件肿物的良恶性鉴别中有重要的临床价值,O-RADS和GI-RADS诊断效能高于IOTA SR,且低年资超声医师对O-RADS,GI-RADS和IOTA SR的一致性好。

Objective To compare the application value of ovarian-adnexal imaging reporting and data system(O-RADS),gynecological imaging reporting and data system(GI-RADS)and simple rules for international ovarian tumor analysis(IOTA SR)in ultrasonic diagnosis of benign and malignant adnexal tumors.Methods A total of 255 patients with adnexal tumors operated in the Second Affiliated Hospital of Zhengzhou University from January 2018 to December 2020 were analyzed retrospectively.All patients were examined by transvaginal or transabdominal ultrasonography and diagnosed by pathology after operation.All adnexal tumors were double-blind evaluated by two ultrasound residents(experience<5 years),and they were evaluated by O-RADS,GI-RADS,IOTA SR.The diagnostic efficacies of O-RADS,GI-RADS and IOTA SR adnexal tumors were compared with pathological results as the gold standard.Results A total of 255 patients(aged from 14 to 85 years old),including 203 benign cases and 52 malignant cases.In terms of sensitivity,O-RADS=GI-RADS>IOTA SR;In terms of accuracy and specificity,O-RADS>GI-RADS>IOTA SR.There were statistically significant differences in O-RADS,GI-RADS and IOTA SR in the diagnosis of malignant adnexal tumors(P<0.001,P=0.008,P=0.049).The Kappa coefficients of O-RADS,GI-RADS and IOTA SR from different low-seniority sonographers were 0.959,0.941 and 0.901,showing superior consistency.Conclusion O-RADS,GI-RADS and IOTA SR have important clinical values in differentiating benign and malignant adnexal tumors.The diagnostic efficacy of O-RADS and GI-RADS is higher than that of IOTA SR,and the consistency in O-RADS,GI-RADS and IOTA SR by low-seniority sonographers is good.