对比增强超声与 O-RADS 超声联合用于附件实性成分病变分类：时间-强度曲线分析与目测评估的比较。

Integrating Contrast-enhanced US to O-RADS US for Classification of Adnexal Lesions with Solid Components: Time-intensity Curve Analysis versus Visual Assessment.

机构信息

From the Department of Ultrasound, the Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, Guangdong, China (M.W., Y.W., M.S., L.H., X.Z.); Department of Ultrasound, Henan Provincial People's Hospital, Zhengzhou, China (R.W.); Department of Ultrasound, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (X.S.); Department of Ultrasound, Children's Hospital of Shanxi (Women Health Center of Shanxi), Taiyuan, China (R.Z.); Ultrasound Diagnosis Center, Shaanxi Provincial People's Hospital, Xi'an, China (L.M.); Department of Ultrasound, The Fifth People's Hospital of Chengdu, Chengdu, China (L.X.); Department of Ultrasound, Huizhou Central People's Hospital, Huizhou, China (H.W.); Department of Ultrasound Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China (T.L.); and Department of Ultrasound, The Third Hospital of BaoGang Group, Maternity Hospital of Bao Tou, Baotou, China (X.M.).

出版信息

Radiol Imaging Cancer. 2024 Nov;6(6):e240024. doi: 10.1148/rycan.240024.

DOI:10.1148/rycan.240024

PMID:39392388

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11615631/

Abstract

Purpose To compare the diagnostic performance of time-intensity curve (TIC) analysis and subjective visual assessment of contrast-enhanced US (CEUS) when integrated with the Ovarian-Adnexal Reporting and Data System (O-RADS) US risk stratification system for characterizing adnexal lesions with solid components. Materials and Methods In this prospective multicenter study conducted from September 2021 to December 2022, female individuals with suspected adnexal lesions containing solid components detected at routine US were enrolled. All participants underwent preoperative CEUS examinations. Histopathologic findings were used as the reference standard for diagnosis. Lesions were classified according to the O-RADS US system. Enhancement of solid tissue compared with the outer myometrium was evaluated using both TIC analysis and subjective visual assessment. The diagnostic performance of O-RADS alone and each CEUS assessment method when integrated with the O-RADS US system was assessed and compared using receiver operating characteristic curve analysis. Results A total of 180 lesions (80 malignant and 100 benign histopathologic outcomes) in 175 participants (median age, 47 years [IQR, 33-56]) were analyzed. Incorporating CEUS (assessed through both TIC analysis and subjective visual assessment) with O-RADS US showed significantly improved diagnostic performance over O-RADS US alone, with an area under the receiver operating characteristic curve (AUC) of 0.86 (95% CI: 0.80, 0.91) compared with 0.78 (95% CI: 0.71, 0.84). No evidence of a difference was observed between the AUCs of TIC analysis and subjective visual assessment in the enhancement evaluation of solid tissue with CEUS for adnexal malignancy categorization ( = .83). Conclusion Subjective visual assessment and TIC analysis of CEUS features when integrated with the O-RADS US scoring system showed comparable diagnostic performance in assigning adnexal malignancy risk. Adnexal Lesions, Contrast-enhanced US, O-RADS, Time-intensity Curve Analysis © RSNA, 2024.

摘要

目的

比较时间-强度曲线（TIC）分析与对比增强超声（CEUS）的主观视觉评估，当整合卵巢-附件报告和数据系统（O-RADS）US 风险分层系统用于对含有实性成分的附件病变进行特征描述时，这两种方法的诊断性能。

材料与方法

本前瞻性多中心研究于 2021 年 9 月至 2022 年 12 月进行，纳入在常规 US 检查中发现含有实性成分的疑似附件病变的女性患者。所有患者均接受术前 CEUS 检查。以组织病理学发现为诊断参考标准。根据 O-RADS US 系统对病变进行分类。使用 TIC 分析和主观视觉评估评估实性组织的增强程度与外肌层的对比。使用受试者工作特征曲线分析评估 O-RADS 单独应用以及每种 CEUS 评估方法与 O-RADS US 系统整合时的诊断性能，并进行比较。

结果

共纳入 175 例患者（中位年龄，47 岁[IQR，33-56]）的 180 个病灶（80 个恶性和 100 个良性组织病理学结果）。与 O-RADS US 单独应用相比，将 CEUS（通过 TIC 分析和主观视觉评估评估）与 O-RADS US 结合应用可显著提高诊断性能，受试者工作特征曲线下面积（AUC）为 0.86（95%CI：0.80，0.91），高于 O-RADS US 的 0.78（95%CI：0.71，0.84）。在使用 CEUS 评估实性组织增强以分类附件恶性肿瘤时，TIC 分析与主观视觉评估在增强评估实性组织方面的 AUC 未见差异（ =.83）。