卵巢-附件影像报告和数据系统联合超声造影鉴别卵巢良恶性肿瘤的临床价值

Clinical value of Ovarian-Adnexal Reporting and Data System combined with contrast-enhanced ultrasound to identify benign and malignant tumors of the ovaries

目的:探究卵巢-附件影像报告和数据系统(Ovarian-Adnexal Reporting and Data System,O-RADS)联合超声造影(contrast-enhanced ultrasound,CEUS)鉴别卵巢良恶性肿瘤的临床价值。方法:回顾并分析159例卵巢肿瘤的经阴道(或经腹部)超声,并进行O-RADS风险分层。同时结合CEUS特征,比较良恶性卵巢肿瘤的灰阶超声和CEUS特征,并观察O-RADS、CEUS以及两者联合对卵巢肿瘤的诊断价值。结果:以病理学检查结果为金标准,本研究159例卵巢肿瘤中,良性肿瘤88例,恶性肿瘤71例。卵巢恶性肿瘤患者的年龄、肿瘤最大径、糖类抗原(carbohydrate antigen,CA)125和人附睾分泌蛋白4(human epididymis protein 4,HE4)均大于良性肿瘤患者(P<0.01);卵巢良恶性肿瘤的灰阶超声特征、彩色血流评分、腹水情况、CEUS的增强时间、增强水平及增强形态存在差异(P<0.01)。O-RADS诊断卵巢恶性肿瘤的灵敏度、特异度分别为93.0%、70.5%,CEUS的灵敏度、特异度分别为85.9%、87.5%,O-RADS联合CEUS的灵敏度、特异度分别为87.3%、88.6%。O-RADS联合CEUS诊断卵巢恶性肿瘤的曲线下面积(area under curve,AUC)与单独使用O-RADS(Z=2.920,P=0.004)或CEUS(Z=3.265,P=0.001)相比,差异有统计学意义。结论:O-RADS联合CEUS较单独使用O-RADS或CEUS鉴别卵巢良恶性肿瘤的临床价值更高。

Objective:To explore the clinical value of the Ovarian-Adnexal Reporting and Data System(O-RADS)combined with contrast-enhanced ultrasound(CEUS)to identify benign and malignant tumors of the ovaries.Methods:Retrospective analysis of 159 cases of ovarian tumors using transvaginal(transabdominal)ultrasound and O-RADS risk stratification was conducted.At the same time,combined with the CEUS,the ultrasound and CEUS features of benign and malignant ovarian tumors were compared,and the diagnostic efficacies of O-RADS,CEUS,and their combination in ovarian tumors were observed.Results:Taking pathology as the gold standard,among the 159 ovarian tumors in this study,88 cases were benign tumors and 71 cases were malignant tumors.The mean age,maximum tumor diameter,carbohydrate antigen(CA)125,and human epididymis protein 4(HE4)of malignant tumor patients were higher than those of benign tumor patients(P<0.01).There were differences in ultrasound characteristics,color Doppler score,ascites,CEUS enhancement time,enhancement level and enhancement morphology between benign and malignant ovarian tumors(P<0.01).The sensitivity and specificity of O-RADS in the diagnosis of ovarian malignant tumors were 93.0%and 70.5%respectively,and CEUS were 85.9%and 87.5%respectively,and O-RADS combined with CEUS were 87.3%and 88.6%respectively.The area under curve(AUC)of O-RADS combined with CEUS was significantly different from O-RADS(Z=2.920,P=0.004)or CEUS(Z=3.265,P=0.001).Conclusion:The clinical value of O-RADS combined with CEUS for ovarian tumors is higher than O-RADS or CEUS.