基于MRI的卵巢-附件报告和数据系统对卵巢附件肿块的评分一致性及诊断价值  

The consistency and application value of MRI-based ovarian-adnexal reporting and data system in the diagnosis of ovarian adnexal masses

作　　者：陈彤 钱许钧 魏超刚 张跃跃[1] 朱智 潘鹏 赵文露[1] 沈钧康[2] Tong Chen;Xujun Qian;Chaogang Wei;Yueyue Zhang;Zhi Zhu;Peng Pan;Wenlu Zhao;Junkang Shen(Department of Imaging,Second Affiliated Hospital of Soochow University,Suzhou 215004,China;Department of Imaging,Second Affiliated Hospital of Soochow University,Institute of Imaging Medicine,Soochow University,Suzhou 215004,China)

机构地区：[1]苏州大学附属第二医院影像科,苏州215004 [2]苏州大学附属第二医院影像科、苏州大学影像医学研究所,苏州215004

出　　处：《中华放射学杂志》2023年第3期282-287,共6页Chinese Journal of Radiology

基　　金：苏州市科教兴卫青年科技项目(KJXW2021012)。

摘　　要：目的探讨基于MRI的卵巢-附件报告和数据系统(O-RADS)对卵巢附件肿块的评分一致性及诊断价值。方法回顾性收集2017年1月至2021年8月苏州大学附属第二医院经病理证实的309例卵巢附件肿块患者的MRI图像资料, 共327个病灶, 病理证实良性病灶250个、交界性21个、恶性56个, 将交界性和恶性病灶归为恶性组(77个), 良性病灶归为良性组(250个)。由2名放射科医师采用基于MRI的O-RADS对所有病灶进行评分, 间隔6个月后再次评分。计算基于MRI的O-RADS各评分病灶中交界性/恶性的占比。使用加权Kappa检验评估医师内、医师间评分结果的一致性, 使用受试者操作特征(ROC)曲线分析基于MRI的O-RADS评分对良恶性卵巢附件病灶的诊断效能。结果 2名医师间基于MRI的O-RADS评分的加权Kappa值为0.810(95%CI 0.764~0.855), 2名医师不同时间评分的加权Kappa值分别为0.848(95%CI 0.806~0.889)、0.875(95%CI 0.835~0.914)。2名医师基于MRI的O-RADS评分1、2、3、4、5分的病灶中交界性/恶性占比分别为0/16、0.8%(1/127)、10.1%(10/99)、76.0%(57/75)、9/10和0/17、0(0/122)、8.0%(8/100)、76.2%(48/63)、84.0%(21/25)。以O-RADS评分>3分为诊断阈值时, 2名医师诊断良恶性卵巢附件病灶的ROC曲线下面积分别为0.928(95%CI 0.895~0.954)和0.942(95%CI 0.911~0.965), 灵敏度分别为0.857、0.896, 特异度分别为0.924、0.924, 准确度分别为0.908、0.917。结论基于MRI的O-RADS对卵巢附件病灶的良恶性评估具有较高的诊断效能, 且医师间和医师内均具有较好的一致性。Objective To explore the consistency of MRI-based ovarian-adnexal report and data system(O-RADS)score and its diagnostic value for ovarian adnexal masses.Methods The MRI data of 309 patients with ovarian adnexal masses confirmed by pathology were retrospectively collected from January 2017 to August 2021 in the Second Affiliated Hospital of Soochow University,including 327 lesions consisted of 250 benign lesions,21 borderline lesions,and 56 malignant lesions confirmed by pathology.Borderline and malignant lesions were classified into the malignant group(n=77)and benign lesions were classified as benign group(n=250).Two radiologists scored all lesions according to the MRI-based O-RADS,and scored again after 6 months.The proportion of borderline/malignant lesions in each MRI-based O-RADS score was calculated.The weighted Kappa test was used to assess the intra-reader and inter-reader consistency of the image interpretation results.The receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic efficacy of MRI-based O-RADS classification for distinguishing benign and malignant ovarian adnexal masses.Results The weighted Kappa value of the MRI-based O-RADS score between the two radiologists was 0.810(95%CI 0.764-0.855),and the weighted Kappa values of the two radiologists′scores at different times were 0.848(95%CI 0.806-0.889)and 0.875(95%CI 0.835-0.914),respectively.The borderline/malignant lesions accounted for 0/16,0.8%(1/127),10.1%(10/99),76.0%(57/75),9/10 and 0/17,0(0/122),8.0%(8/100),76.2%(48/63),and 84.0%(21/25)of the lesions in the two radiologists based on the MRI O-RADS score of 1,2,3,4,and 5,respectively.When adopting O-RADS score>3 as a cut-off value,the area under the ROC curve of the two radiologists for distinguishing benign and malignant ovarian adnexal masses was 0.928(95%CI 0.895-0.954)and 0.942(95%CI 0.911-0.965),respectively.The sensitivity was 0.857 and 0.896,the specificity was 0.924 and 0.924,and the accuracy was 0.908 and 0.917 respectively.Conclusion The MRI-bas

关 键 词：卵巢肿瘤 磁共振成像 卵巢-附件报告和数据系统 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.31[医药卫生—诊断学]