Patel M D, Feldstein V A, Lipson S D, Chen D C, Filly R A
Department of Radiology, Mayo Clinic Scottsdale, AZ 85259, USA.
AJR Am J Roentgenol. 1998 Oct;171(4):1061-5. doi: 10.2214/ajr.171.4.9762997.
This study was undertaken to determine if the diagnosis of cystic teratomas of the ovary can be made by experienced sonologists using only specific associated sonographic features.
Two sonologists independently reviewed the sonograms of 252 adnexal masses. For each mass, each sonologist recorded sonographic features using a standardized checklist, which included four descriptions associated with cystic teratomas. From a list of diagnostic possibilities, each reviewer chose one specific conclusion, with emphasis on achieving the highest combination of sensitivity and positive predictive value for any particular diagnosis. The sensitivity, positive predictive value, and positive likelihood ratio for the diagnosis of cystic teratoma were evaluated for each sonographic finding and for each sonologist's interpretation.
Of the 252 masses, 74 cystic teratomas were found, 55 of which showed two or more associated sonographic features. Each reviewer had a 98% positive predictive value with 85% sensitivity for the diagnosis and identification of cystic teratomas (positive likelihood ratio = 152). The positive predictive value was 100% when an adnexal mass had two or more sonographic features associated with dermoid masses. The positive predictive value for individual sonographic features associated with dermoid masses was 80% for a shadowing echodensity, 75% for regionally bright echoes, 50% for hyperechoic lines and dots, and 20% for a fluid-fluid level.
An adnexal mass showing two or more of the sonographic features associated with cystic teratomas can be confidently diagnosed as a cystic teratoma.
本研究旨在确定经验丰富的超声科医生仅通过特定的相关超声特征能否做出卵巢囊性畸胎瘤的诊断。
两名超声科医生独立回顾了252例附件包块的超声图像。对于每个包块，每位超声科医生使用标准化检查表记录超声特征，该检查表包括与囊性畸胎瘤相关的四种描述。从一系列诊断可能性中，每位审阅者选择一个特定结论，重点是实现任何特定诊断的敏感性和阳性预测值的最高组合。对每个超声检查结果和每位超声科医生的解读评估囊性畸胎瘤诊断的敏感性、阳性预测值和阳性似然比。
在252个包块中，发现74个囊性畸胎瘤，其中55个显示出两种或更多相关超声特征。每位审阅者对囊性畸胎瘤的诊断和识别阳性预测值为98%，敏感性为85%（阳性似然比 = 152）。当附件包块有两种或更多与皮样囊肿相关的超声特征时，阳性预测值为100%。与皮样囊肿相关的单个超声特征的阳性预测值分别为：阴影回声密度为80%，局部明亮回声为75%，高回声线和点为50%，液-液平面为20%。
显示出两种或更多与囊性畸胎瘤相关超声特征的附件包块可确诊为囊性畸胎瘤。
