Lu Beilei, Liu Chang, Qi Jiuling, He Wanyuan, Shi Tingyan, Zhu Yuli, Huang Beijian
Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China; Shanghai Institute of Medical Imaging, Shanghai 200032, PR China; Institute of Medical Ultrasound and Engineering, Fudan University, Shanghai 200032, PR China.
Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai 200072, PR China.
J Gynecol Obstet Hum Reprod. 2023 Apr;52(4):102564. doi: 10.1016/j.jogoh.2023.102564. Epub 2023 Mar 2.
To explore the diagnostic accuracy of ovarian solid tumors by 2D ultrasound and contrast-enhanced ultrasound (CEUS).
We retrospectively evaluated the CEUS characteristics of prospectively enrolled 16 benign and 19 malignant ovarian solid tumors. We performed International Ovarian Tumor Analysis (IOTA) simple rules and Ovarian-Adnexal Reporting and Data System (O-RADS) for all lesions, and evaluated their characteristics on CEUS. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of IOTA simple rules, O-RADS and CEUS in the diagnosis of ovarian solid malignancies were calculated.
The combination of time to wash-in earlier than or equal to the myometrium, time to PI earlier than or equal to the myometrium and the intensity at peak were higher than or equal to myometrium with sensibility of 0.947, specificity of 0.938, and PPV of 0.947, NPV of 0.938 which were higher than IOTA simple rules and O-RADS. According to the definition of ovarian solid tumor, the diagnostic accuracy of O-RADS 3 and CEUS were both 100%, CEUS improved the accuracy of O-RADS 4 from 47.4% to 87.5%, the accuracy of solid smooth CS 4 in O-RADS 5 and CEUS were both 100%, CEUS improved the accuracy of solid irregular in O-RADS 5 from 70% to 87.5%.
For ovarian solid tumors that are difficult to distinguish between benign and malignant, the introduction of CEUS on the basis of 2D classification criteria can significantly improve the diagnostic accuracy.
探讨二维超声及超声造影（CEUS）对卵巢实性肿瘤的诊断准确性。
我们回顾性评估了前瞻性纳入的16例良性和19例恶性卵巢实性肿瘤的CEUS特征。我们对所有病变进行了国际卵巢肿瘤分析（IOTA）简单规则和卵巢附件报告与数据系统（O-RADS），并评估了它们在CEUS上的特征。计算了IOTA简单规则、O-RADS和CEUS在诊断卵巢实性恶性肿瘤中的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性。
早于或等于子宫肌层的流入时间、早于或等于子宫肌层的达峰时间以及峰值强度高于或等于子宫肌层的组合，其敏感性为0.947，特异性为0.938，PPV为0.947，NPV为0.938，高于IOTA简单规则和O-RADS。根据卵巢实性肿瘤的定义，O-RADS 3和CEUS的诊断准确性均为100%，CEUS将O-RADS 4的准确性从47.4%提高到87.5%，O-RADS 5中实性光滑CS 4和CEUS的准确性均为100%，CEUS将O-RADS 5中实性不规则的准确性从70%提高到87.5%。
对于难以鉴别良恶性的卵巢实性肿瘤，在二维分类标准的基础上引入CEUS可显著提高诊断准确性。
