Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, Pamplona, Spain.
Eur J Obstet Gynecol Reprod Biol. 2012 Mar;161(1):92-5. doi: 10.1016/j.ejogrb.2011.12.002. Epub 2011 Dec 22.
To assess the agreement between three-dimensional volume off-line analysis as compared to real-time ultrasound for assessing adnexal masses.
Ninety-nine non-consecutive women diagnosed as having an adnexal mass were assessed by transvaginal power Doppler ultrasound. One single examiner performed all ultrasound examinations. Based on the examiner's subjective evaluation using gray scale and Doppler ultrasound findings a presumptive diagnosis (benign or malignant) was provided after real-time ultrasound was performed. Once real-time was done a 3D volume of the adnexal mass was acquired and stored by this examiner. Two examiners, unaware of the real-time ultrasound results, evaluated the 3D volumes using multiplanar display and virtual navigation and also had to provide a presumptive diagnosis (benign or malignant). These two examiners, like the first one, had information about patient's age, menopausal status and complaints. All women underwent surgery or were followed-up until cyst resolution. Histologic diagnosis was used as gold standard. Cysts that resolved spontaneously were considered as benign for analytical purposes. The Kappa index was used to assess the agreement between real time ultrasound and 3D volume analysis. Sensitivity and specificity of both methods were calculated and compared using McNemar test.
Forty-one masses were malignant and 58 were benign. Agreement between real-time ultrasound and 3D volume analysis was good for both off-line examiners (Kappa index: 0.82, 95% CI: 0.70-0.93 and 0.78, 95% CI: 0.65-0.90). Sensitivities for real-time ultrasound and 3D volume analyses were 100%, 93% and 90%, respectively (p>0.05). Specificities for real-time ultrasound and 3D volume analyses were 91%, 84% and 86%, respectively (p>0.05).
Off-line 3D volume analysis may be a useful method for assessing adnexal masses, showing a good agreement with real-time ultrasound and having a similar diagnostic performance.
评估三维体积离线分析与实时超声在评估附件肿块中的一致性。
对 99 例非连续的被诊断为附件肿块的女性进行经阴道彩色能量多普勒超声检查。一名单一的检查者进行了所有的超声检查。根据检查者在实时超声检查后基于灰阶和多普勒超声检查结果的主观评估，提供了一个初步诊断（良性或恶性）。完成实时超声检查后，由该检查者获得并存储附件肿块的 3D 体积。两名检查者，不知道实时超声结果，使用多平面显示和虚拟导航评估 3D 体积，并提供初步诊断（良性或恶性）。这两名检查者与第一位检查者一样，有患者年龄、绝经状态和症状的信息。所有女性均接受手术或随访至囊肿消退。组织学诊断被用作金标准。自发消退的囊肿在分析时被认为是良性的。kappa 指数用于评估实时超声和 3D 体积分析之间的一致性。使用 McNemar 检验计算并比较两种方法的敏感性和特异性。
41 个肿块为恶性，58 个为良性。实时超声和 3D 体积分析的离线检查者之间的一致性良好（kappa 指数：0.82，95%可信区间：0.70-0.93 和 0.78，95%可信区间：0.65-0.90）。实时超声和 3D 体积分析的敏感性分别为 100%、93%和 90%（p>0.05）。实时超声和 3D 体积分析的特异性分别为 91%、84%和 86%（p>0.05）。
离线 3D 体积分析可能是评估附件肿块的一种有用方法，与实时超声具有良好的一致性，且具有相似的诊断性能。
