经腹部与经阴道超声造影联合超声卵巢-附件报告和数据系统诊断附件肿物的对比研究  

Comparison of diagnostic performance of adding value of transabdominal and transvaginal contrast-enhanced ultrasound to Ovarian-Adnexal Reporting and Data System Ultrasound risk stratification in the evaluation of adnexal masses

作　　者：吴曼丽 苏漫婷 王睿丽[2] 孙晓枫 张瑞 穆靓[5] 肖莉 温红[7] 刘婷婷 孟晓涛 张新玲[1] Wu Manli;Su Manting;Wang Ruili;Sun Xiaofeng;Zhang Rui;Mu Liang;Xiao Li;Wen Hong;Liu Tingting;Meng Xiaotao;Zhang Xinling(Department of Ultrasound,the Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China;Department of Ultrasound,Henan Provincial People′s Hospital,Zhengzhou 450003,China;Department of Ultrasound,Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Ultrasound,Children′s Hospital of Shanxi(Women Health Center of Shanxi),Taiyuan 030000,China;Ultrasound Diagnosis Center,Shaanxi Provincial People′s Hospital,Xi′an 710068,China;Department of Ultrasound,the Fifth People′s Hospital of Chengdu,Chengdu 611130,China;Department of Ultrasound,Huizhou Central People′s Hospital,Huizhou 516001,China;Department of Ultrasound Medicine,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Ultrasound,the Third Hospital of BaoGang Group,the Maternity Hospital of Baotou,Baotou 014000,China)

机构地区：[1]中山大学附属第三医院超声科,广州510630 [2]河南省人民医院超声科,郑州450003 [3]华中科技大学同济医学院附属武汉市中心医院超声影像科,武汉430030 [4]山西省儿童医院(妇幼保健院)超声科,太原030000 [5]陕西省人民医院超声诊断中心,西安710068 [6]成都市第五人民医院超声医学科,成都611130 [7]惠州市中心人民医院超声医学科,惠州516001 [8]广西医科大学第一附属医院超声医学科,南宁530021 [9]内蒙古包头市包钢三医院超声医学科,包头014000

出　　处：《中华超声影像学杂志》2024年第5期385-391,共7页Chinese Journal of Ultrasonography

基　　金：广东省自然科学基金面上项目(2022A1515012027);广州市校(院)联合资助项目——(登峰医院)基础研究项目(SL2022A03J00358);中山大学高校基本科研业务费青年教师培育项目(23qnpy142);广州市基础与应用基础研究(2024A04J4786)。

摘　　要：目的探讨及比较经腹部与经阴道超声造影(CEUS)联合超声卵巢-附件报告和数据系统(O-RADS US)对附件肿物的诊断效能。方法回顾性分析2021年9月至2022年12月在多中心研究单位就诊的175例含实性成分的附件肿块患者(共180个病灶),均接受彩色多普勒超声及CEUS检查,其中107个病灶行经腹部CEUS检查,58个病灶行经阴道CEUS检查,15个病灶同时行经腹和经阴道CEUS检查。所有入组患者均取得手术病理结果。由高年资超声医师使用Vuebox软件对图像进行超声O-RADS分类及CEUS评估,根据病灶CEUS特征进行O-RADS升级或降级。构建ROC曲线,计算曲线下面积(AUC),评估及比较经腹部与经阴道CEUS联合O-RADS US分类的诊断效能。结果经腹部与经阴道CEUS联合O-RADS US分类的诊断效能均显著高于普通超声O-RADS分类(经腹部:AUC 0.83比0.76,P=0.018;经阴道:AUC 0.92比0.81,P=0.013)。经阴道CEUS联合O-RADS US分类诊断效能优于经腹部CEUS联合O-RADS US分类(P=0.047)。当病灶最大径≤40 mm,经腹部CEUS联合O-RADS US的诊断效能最低,AUC为0.73。结论经阴道CEUS联合O-RADS US分类对附件肿物良恶性的诊断效能优于经腹部CEUS。当病灶最大径≤40 mm时,建议使用经阴道CEUS作为首选的检查方式。Objective To compare and explore the diagnostic performance of adding value of transabdominal and transvaginal contrast-enhanced ultrasound(CEUS)to Ovarian-Adnexal Reporting and Data System(O-RADS US)risk stratification and management system in differential diagnosis of adnexal masses.Methods A total of 180 adnexal masses with solid components in 175 women were enrolled retrospectively between September 2021 and November 2022.All patients underwent routine Doppler ultrasound examinations and CEUS examinations.Among these masses,107 masses underwent with transabdominal CEUS,58 masses underwent with transvaginal CEUS,and 15 masses underwent both transvaginal and transabdominal CEUS.All patients were scheduled for surgery and pathological results served as the reference standard.Routine Doppler ultrasound and CEUS images and video were reviewed by a subspecialty radiologist using Vuebox software.The O-RADS US was downgraded or upgraded according to the CEUS characteristics of the masses.The diagnostic accuracy was assessed using ROC curve analysis.The area under the ROC curve(AUC)was calculated to compare the diagnostic performance of adding value of transabdominal and transvaginal CEUS to O-RADS US.Results The diagnostic performance of adding transabdominal and transvaginal CEUS to O-RADS US were both significantly higher than of O-RADS US alone(transabdominal CEUS:AUC 0.83 vs 0.76,P=0.018;transvaginal CEUS:AUC 0.92 vs 0.81,P=0.013).Combination of transvaginal CEUS and O-RADS US was superior to that of combination of transabdominal and O-RADS US in the differential diagnosis of adnexal masses(P=0.047).When the maximal diameter of adnexal masses≤40 mm,transabdominal combined with O-RADS US presented the lowest diagnostic performance,with an AUC of 0.73.Conclusions Combination of transvaginal CEUS and O-RADS US was superior to that of combination of transabdominal and O-RADS US in assessing adnexal masses with solid components.When the maximal diameter of adnexal masses≤40 mm,transvaginal CEUS examination was rec

关 键 词：超声造影 超声卵巢-附件报告和数据系统 附件肿物 鉴别诊断 

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]