Ruiz Mireille, Labauge Pénélope, Louboutin Anne, Limot Olivier, Fauconnier Arnaud, Huchon Cyrille
Department of Gynecology and Obstetrics, CHI Poissy-St-Germain, 10, rue du Champ Gaillard, 78300 Poissy, France.
Department of Radiology, CHI Poissy-St-Germain, 10, rue du Champ Gaillard, 78300 Poissy, France.
Eur J Obstet Gynecol Reprod Biol. 2016 Oct;205:115-9. doi: 10.1016/j.ejogrb.2016.07.493. Epub 2016 Aug 24.
To investigate the prognostic value of ADNEX Magnetic Resonance Imaging Scoring in the preoperative management of adnexal masses.
We performed a retrospective study on patients who underwent surgery for an adnexal mass, with prior exploration by Magnetic Resonance Imaging (MRI), at the Gynecology Department of the Poissy Teaching Hospital between May 2012 and August 2014. MRI data were retrospectively read by radiologists, without knowledge of the histology, and classified according to the criteria of the ADNEX MR score. The radiological presumption of benign or malignant mass was compared with the final histological diagnosis. We calculated the sensitivity, specificity, positive and negative likelihood ratios and ROC curve of the ADNEX MR score with their 95% confidence intervals (95%CI).
One-hundred-and-forty-eight patients were included in the study of which 24 had malignant or borderline ovarian tumors. The proportion of malignant or borderline ovarian tumors in each class of the ADNEX MR score in our study was: ADNEX I: 0% (95%CI, 0-8); ADNEX II: 1.7% (95%CI, 0.04-8.9); ADNEX III: 7.7% (95%CI, 0.2-36); ADNEX IV: 57.1% (95%CI, 34.2-78.8) and ADNEX V: 100% (95%CI, 69.2-100). Thus, for an ADNEX MR score greater than or equal to 4, the sensitivity was 91.7% (95%CI, 73-99) and the specificity 92.7% (95%CI, 86.7-96.6) for the diagnosis of a malignant or borderline ovarian tumor. The area under the ROC curve was 0.92 (95% CI%, 0.86-0.98).
MRI, coupled with the use of the ADNEX MR scoring system, can accurately classify adnexal masses into low-risk (ADNEX MR score <4) or high-risk (ADNEX MR score ≥4) group, thereby allowing for appropriate preoperative counseling and planning for surgery.
探讨附件磁共振成像评分在附件包块术前管理中的预后价值。
我们对2012年5月至2014年8月在普瓦西教学医院妇科因附件包块接受手术且术前进行过磁共振成像（MRI）检查的患者进行了一项回顾性研究。放射科医生在不知组织学结果的情况下对MRI数据进行回顾性解读，并根据附件磁共振成像（ADNEX MR）评分标准进行分类。将良性或恶性包块的影像学推测与最终组织学诊断进行比较。我们计算了ADNEX MR评分的敏感性、特异性、阳性和阴性似然比以及ROC曲线及其95%置信区间（95%CI）。
148例患者纳入本研究，其中24例患有恶性或交界性卵巢肿瘤。在我们的研究中，ADNEX MR评分各等级中恶性或交界性卵巢肿瘤的比例为：ADNEX I：0%（95%CI，0 - 8）；ADNEX II：1.7%（95%CI，0.04 - 8.9）；ADNEX III：7.7%（95%CI，0.2 - 36）；ADNEX IV：57.1%（95%CI，34.2 - 78.8）；ADNEX V：100%（95%CI，69.2 - 100）。因此，对于ADNEX MR评分大于或等于4的情况，诊断恶性或交界性卵巢肿瘤的敏感性为91.7%（95%CI，73 - 99），特异性为92.7%（95%CI，86.7 - 96.6）。ROC曲线下面积为0.92（95%CI，0.86 - 0.98）。
MRI结合ADNEX MR评分系统可将附件包块准确分为低风险（ADNEX MR评分<4）或高风险（ADNEX MR评分≥4）组，从而为术前咨询和手术规划提供依据。
