Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
Abdom Radiol (NY). 2023 Jan;48(1):358-366. doi: 10.1007/s00261-022-03688-x. Epub 2022 Sep 29.
To explore ways to improve O-RADS MRI scoring for fat-containing adnexal masses, by investigating methods for quantifying solid tissue volume and fat distribution and evaluating their associations with malignancy.
This retrospective, single-center study included patients with fat-containing adnexal masses on MRI during 2008-2021. Two radiologists independently reviewed overall size (Size), size of any solid tissue (Size), size of solid tissue that was not Rokitansky nodule (Size), and fat distribution. Wilcoxon test, Fisher-exact test, and ROC curve analysis were performed. Reference standard was pathology or follow-up > 24 months.
188 women (median age 35 years) with 163 benign and 25 malignant lesions were included. Size (R1, 9.9 cm vs 5.9 cm; R2, 12.4 cm vs 6.0 cm), Size (R1, 5.1 cm vs 1.2 cm; R2, 3.2 cm vs 0.0 cm), Size (R1, 5.1 cm vs 0.0 cm; R2, 3.1 cm vs 0.0 cm), and fat distribution differed significantly between malignant and benign lesions (p < 0.01). Area under ROC curve was greatest using Size (R1, 0.83; R2, 0.86) vs Size (R1, 0.78; R2, 0.81) or Size (R1, 0.79; R2, 0.81), though differences were non-significant (p = 0.48-0.93). Cutoffs for Size (R1, ≥ 1.2 cm; R2, ≥ 1.0 cm) yielded sensitivity and specificity of 0.72 and 0.93 (R1) and 0.76 and 0.95 (R2). Among immature teratomas, 85.7% displayed scattered fat.
Overall size, size of (any or non-Rokitansky-nodule) solid tissue, and fat distribution differed between benign and malignant fat-containing adnexal masses. Incorporating these would constitute simple and practical approaches to refining O-RADS MRI scoring.
通过研究量化实性组织体积和脂肪分布的方法，并评估它们与恶性肿瘤的关系，探讨提高含有脂肪附件肿块 O-RADS MRI 评分的方法。
本回顾性单中心研究纳入了 2008 年至 2021 年期间 MRI 检查显示含有脂肪附件肿块的患者。两名放射科医生分别对整体大小（Size）、任何实性组织的大小（Size）、非罗基坦斯基结节的实性组织大小（Size）和脂肪分布进行评估。采用 Wilcoxon 检验、Fisher 精确检验和 ROC 曲线分析。参考标准为病理或随访>24 个月。
纳入了 188 名女性（中位年龄 35 岁），其中 163 例为良性病变，25 例为恶性病变。大小（R1：9.9cm 比 5.9cm；R2：12.4cm 比 6.0cm）、大小（R1：5.1cm 比 1.2cm；R2：3.2cm 比 0.0cm）、大小（R1：5.1cm 比 0.0cm；R2：3.1cm 比 0.0cm）和脂肪分布在恶性和良性病变之间有显著差异（p<0.01）。ROC 曲线下面积最大的是使用大小（R1：0.83；R2：0.86）与大小（R1：0.78；R2：0.81）或大小（R1：0.79；R2：0.81），但差异无统计学意义（p=0.48-0.93）。大小（R1：≥1.2cm；R2：≥1.0cm）的截断值可获得 0.72 和 0.93（R1）和 0.76 和 0.95（R2）的敏感性和特异性。在不成熟畸胎瘤中，85.7%显示散在脂肪。
良性和恶性含有脂肪的附件肿块之间存在总体大小、（任何或非罗基坦斯基结节）实性组织的大小和脂肪分布的差异。纳入这些因素将构成改进 O-RADS MRI 评分的简单实用方法。
