ADNEX MR评分系统在超声不确定附件肿块诊断中的应用价值  

Application Value of ADNEX MR Scoring System in the Diagnosis of Sonographically Indeterminate Adnexal Masses

作　　者：李桂军[1] 文鹏[1] 黄丽霞[1] 向恋 LI Guijun;WEN Peng;HUANG Lixia;XIANG Lian(Department of Radiology,Hunan Maternal and Child Health Hospital,Changsha Hunan 410008,China)

机构地区：[1]湖南省妇幼保健院放射科,湖南长沙410008

出　　处：《华南国防医学杂志》2022年第11期879-883,共5页Military Medical Journal of South China

基　　金：湖南省卫生健康委科研项目(20190136)。

摘　　要：目的评估ADNEX MR评分系统在超声不确定附件肿块(adnexal masses,AM)诊断中的有效性和可重复性。方法选取2018-01-01/2021-09-30日在作者医院接受盆腔磁共振(magnetic resonance,MR)检查超声不确定AM的265例女性患者为研究对象,超声检查不确定AM共286个(218个良性和68个恶性)。3名放射科医生独立审查磁共振成像(magnetic resonance imaging,MRI)图像。根据ADNEX MR评分系统对AM进行评分。通过受试者工作特征(receiver operating characteristic,ROC)曲线分析评估该系统的诊断性能。结果ADNEX MR评分系统在放射医生间一致性非常好(κ=0.861,95%CI:0.747~0.929),并且各MRI特征的一致性均>0.762。286个AM ADNEX MR评分为2、3、4、5分的病变数分别为0、3、22、43个,其恶性率分别为0%、9.68%、57.89%和100.00%,不同ADNEX MR评分的AM恶性率差异有统计学意义(P<0.001)。当评分≥3时,ADNEX MR评分系统预测恶性AM的曲线下面积(area under the curve,AUC)为0.947(95%CI:0.920~0.975,P<0.001),诊断恶性AM的准确度、敏感度、特异度、阳性预测值和阴性预测值分别为93.36%、95.59%、92.66%、80.25%和98.54%。结论ADNEX MR评分系统诊断超声不确定AM具有较高有效性和重复性,可作为我国妇女超声不确定AM的标准化MRI报告。Objective To evaluate the effectiveness and repeatability of the ADNEX MR scoring system in the diagnosis of sonographically indeterminate adnexal masses(AM).Methods A total of 265 female patients who underwent pelvic magnetic resonance(MR)examination with sonographically indeterminate AM in the author′s hospital from January 1,2018 to September 30,2021 were selected as the research objects,286 indeterminate AM(218 benign and 68 malignant)were examined by ultrasound.Three radiologists independently reviewed the magnetic resonance imaging(MRI)images.The AM were scored according to the ADNEX MR scoring system.The diagnostic performance of the system was evaluated and analyzed by receiver operating characteristic(ROC)curve.Results The ADNEX MR scoring system was very consistent among radiologists(κ=0.861,95%CI:0.747-0.929),and the consistency of each MRI feature was>0.762.The 286 lesions with AM ADNEX MR scores of 2,3,4 and 5 were 0,3,22 and 43 respectively,and the malignant rate of it were 0%,9.68%,57.89%and 100.00%respectively,and the malignant rate of AM with different ADNEX MR scores was statistically significant(P<0.001).When the score was≥3,the ADNEX MR scoring system predicted the area under the curve(AUC)of malignant AM was 0.947(95%CI:0.920-0.975,P<0.001),the accuracy,sensitivity,specificity,positive predictive value and negative predictive value of the diagnosis of malignant AM were 93.36%,95.59%,92.66%,80.25%and 98.54%respectively.Conclusion The ADNEX MR scoring system has high validity and reproducibility in the diagnosis of sonographically indeterminate AM,and can be used as a MRI standardized reporting of sonographically indeterminate AM in Chinese women.

关 键 词：磁共振成像 超声不确定附件肿块 有效性 可重复性 ADNEX MR评分系统 

分 类 号：R737.71[医药卫生—肿瘤]