超声O-RADS分类对卵巢附件肿块良恶性的诊断价值研究  

Diagnostic value of O-RADS ultrasound classification in distinguishing between benign and malignant ovarian adnexal mass

作　　者：邱春花[1] 董盖英 区文财[1] Qiu Chunhua;Dong Gaiying;Ou Wencai(Department of Ultrasound Medicine,Guangzhou First People’s Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院超声医学科,510180

出　　处：《中华生物医学工程杂志》2021年第2期173-178,共6页Chinese Journal of Biomedical Engineering

基　　金：广州市卫生健康科技项目(20211A010008)。

摘　　要：目的探讨卵巢附件肿块超声报告和数据管理系统(O-RADS)分类在卵巢附件肿块中的诊断价值,并评估观察者之间的一致性。方法两名超声医师回顾性分析本院收集的2018年1月至2020年6月271例经病理证实的卵巢附件肿块,按照美国放射学院(ACR)提出的判定标准进行O-RADS分类,将肿块分为3、4、5类,以病理结果为金标准,分析O-RADS各分类中恶性病灶的检出率。计算超声O-RADS分类对卵巢附件肿块良恶性的诊断效能,得出ROC曲线下面积。结果两名超声医师对卵巢附件肿块O-RADS分类存在较好的一致性(Kappa值=0.766,P=0.000);超声O-RADS 3、4、5各分类的恶性病灶检出率分别为1.6%、28.7%、70.6%;以O-RADS 3类判定为良性病灶,4、5类判定为恶性病灶,进行统计学分析,诊断卵巢附件肿块良恶性差异具有统计学意义(χ^(2)=62.520,P<0.05),其诊断卵巢附件肿块的灵敏度96.9%(63/65),特异度为60.2%(124/206),总正确率为69.0%(187/271),阳性预测值为43.4%(63/145),阴性预测值为98.4%(124/126)。超声O-RADS分类诊断的ROC曲线下面积为0.861。结论超声O-RADS分类对卵巢附件肿块良恶性有较高的诊断效能,值得临床推广应用。Objective To determine the diagnostic value of ovarian-adnexal reporting and data system(O-RADS)ultrasound classification in distinguishing between benign and malignant ovarian adnexal mass,and to assess the consistency between observers.Methods Two sonographers reviewed the sonography of 271 cases of pathologically confirmed ovarian adnexal masses in our hospital between January 2018 and June 2020.The O-RADS classification was carried out according to the criteria by American College of Radiology(ACR),with the masses classified by risk levels 3,4,and 5.Using pathological findings as the gold standard,the detection yield of malignant lesions with O-RADS classification was analyzed.The diagnostic efficacy of O-RADS ultrasound classification for benign and malignant ovarian adnexal masses was calculated,and the area under ROC curve was obtained.Results The two sonographers presented good agreement in O-RADS classification of ovarian adnexal mass(Kappa=0.766,P=0.000).The ultrasound detection yields of malignant lesions with O-RADS 3,4,and 5 risk levels were 1.6%,28.7%,and 70.6%,respectively.When considering O-RADS 3 lesions as benign,O-RADS 4 and 5 as malignant lesions,our statistical analysis showed significant difference in ultrasound diagnosis between benign and malignant ovarian adnexal masses(χ^(2)=62.520,P<0.05).The sensitivity and specificity of ultrasound diagnosis for the ovarian adnexal masses were 96.9%(63/65)and 60.2%(124/206),with an overall accuracy of 69.0%(187/271),a positive predictive value of 43.4%(63/145)and a negative predictive value of 98.4%(124/126).The area under the ROC curve of O-RADS ultrasound classification was 0.861.Conclusion O-RADS ultrasound classification yields high diagnostic efficiency for benign and malignant ovarian adnexal masses,and therefore warrants widespread use in clinical setting.

关 键 词：超声检查 卵巢肿瘤 O-RADS分类 卵巢疾病 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.75[医药卫生—诊断学]