不同观察者基于卵巢-附件影像报告和数据系统诊断卵巢附件肿块的一致性研究  

A consistent study of the diagnosis of ovarian adnexal mass by different seniority sonographers based on the ovarianadnexal reporting and data system

作　　者：谢映鲜[1] 王钰丹 沈若霞[1] 张埕宁 张磊[2] 年英华[1] XIE Yingxian;WANG Yudan;SHEN Ruoxia;ZHANG Chengning;ZHANG Lei;NIAN Yinghua(Department of Ultrasound,The Third Affiliated Hospital of Kunming Medical University,Tumor Hospital of Yunnan Province,Kunming 650118,China;Department of Gynecological Tumor,The Third Affiliated Hospital of Kunming Medical University,Tumor Hospital of Yunnan Province,Kunming 650118,China)

机构地区：[1]昆明医科大学第三附属医院云南省肿瘤医院超声医学科,云南昆明650118 [2]昆明医科大学第三附属医院云南省肿瘤医院妇瘤科,云南昆明650118

出　　处：《医学影像学杂志》2024年第2期91-94,共4页Journal of Medical Imaging

基　　金：国家自然科学基金资助项目(编号:82160524)。

摘　　要：目的 探讨不同年资超声医师使用卵巢-附件影像报告和数据系统(O-RADS)判读观察指标的一致性,以及对卵巢附件肿块的诊断效能评价。方法 选取经手术组织学病理确诊的244例(304个病灶)卵巢附件肿块患者的超声存储图像。2位不同年资超声医师按照O-RADS分类标准对每个肿块进行观察指标盲读,进行O-RADS分类。对照病理结果,采用Kappa检验评估一致性,构建ROC曲线,分析两者诊断卵巢肿块的诊断效能。结果 2位不同年资超声医师根据O-RADS分类标准对卵巢附件肿块外部轮廓、内部回声、血流信号、腹水以及腹膜增厚或腹膜结节5项观察指标判读的一致性检验Kappa值分别为0.748、0.835、0.652、0.973、0.979,差异有统计学意义(P<0.001);2位超声医师对同一肿块O-RADS分类一致性检验Kappa值为0.795,差异有统计学意义(P<0.001);2位医师O-RADS分类的ROC曲线面积为0.897、0.918,准确率为80.92%、80.92%,灵敏度为77.3%、76.7%,特异度为88.3%、91.5%,差异均无统计学意义(P>0.05)。结论 不同年资超声医师对O-RADS观察指标判读具有较高一致性;O-RADS分类标准对卵巢肿块的诊断也具有较高诊断效能。Objective To discuss the consistency of observational indicators that were finished by sonographers of different seniority with the Ovarian-Adnexal Reporting and Data System(O-RADS),and to evaluate the diagnostic efficacy of ovarian adnexal masses.Methods We analyzed the ultrasonographic images of 244 patients with ovarian accessory masses(in total,304 lesions)who were diagnosed by surgery and histopathology.Two sonographers of different seniority analyzed and classified the observation indicators of every ovarian accessory masses,controlled the histopathological result,tested the congruence of evaluation by kappa,built the ROC curve.O-RADS performance was assessed by area under the receiver operating characteristic curve(AUC),sensitivity,specificity,and accuracy.Results According to the O-RADS classification,two sonographers of different seniority interpreted the concordance of five observation indicators that were external profile,internal echo,blood flow signal,ascites and peritoneal thickening or peritoneal nodule of the ovarian masses,their Kappa coefficient respectively were 0.748、0.835,0.652,0.973,0.979,P<0.001.The Kappa coefficient of the same ovarian mass was 0.795,P<0.001,which was diagnosed by two sonographers with O-RADS.According to the O-RADS classification,the two physicians tested the following coefficients for ROC:the area under the curve(AUC)was 0.897 and 0.918,diagnostic accuracy was 80.92% and 80.92%,sensitivity was 77.3%is 76.7%,specificity was 88.3%and 91.5%,all of these differences had no statistical significance.Conclusion There was a high consistency in the interpretation of observational indicators of O-RADS by different seniority sonographers,The O-RADS classification has high diagnostic efficiency for ovarian masses.

关 键 词：卵巢肿块 影像报告和数据系统 超声检查 

分 类 号：R737.31[医药卫生—肿瘤] R445.1[医药卫生—临床医学]