A study on the value of contrast-enhanced ultrasound in adjusting O-RADS grading of ovarian adnexal masses

LIU Hongyan; LI Fan; DU Lianfang

doi:10.19732/j.cnki.2096-6210.2024.04.013

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A study on the value of contrast-enhanced ultrasound in adjusting O-RADS grading of ovarian adnexal masses

更新时间：2025-12-15

- A study on the value of contrast-enhanced ultrasound in adjusting O-RADS grading of ovarian adnexal masses
- Vol. 33, Issue 4, Pages: 425-431(2024)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2024.04.013
  CLC：
- Published Online：12 September 2024，
  
  Published：12 September 2024
- 稿件说明：
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刘洪艳,李凡,杜联芳. 超声造影对卵巢附件肿块调整O-RADS分级的价值研究[J]. 肿瘤影像学, 2024, 33(4): 425-431 https://doi.

org/10.19732/j.cnki.2096-6210.2024.04.013
刘洪艳,李凡,杜联芳. 超声造影对卵巢附件肿块调整O-RADS分级的价值研究[J]. 肿瘤影像学, 2024, 33(4): 425-431 https://doi. DOI： 10.19732/j.cnki.2096-6210.2024.04.013.

org/10.19732/j.cnki.2096-6210.2024.04.013 DOI：

摘要

目的：

探讨超声造影（contrast-enhanced ultrasound，CEUS）在调整卵巢附件肿块的卵巢附件超声报告和数据风险系统（Ovarian-Adnexal Reporting and Data System，O-RADS）分级中的应用价值。

方法：

选取上海交通大学医学院附属第一人民医院接诊的98例行二维超声及CEUS检查的卵巢-附件肿块患者作为研究对象，二维声像图通过O-RADS进行评估，并分析CEUS灌注特征。以病理学检查结果为金标准，绘制受试者工作特征（receiver operating characteristic，ROC）曲线分析O-RADS及O-RADS联合CEUS对卵巢-附件恶性肿块的诊断效能。

结果：

病理学检查结果显示恶性肿块25例，良性肿块73例。恶性肿块囊壁/分隔厚度≥3 cm、有实性成分、乳头状突起≥4个、血流评分3~4分、有腹水者占比分别为68.00%、80.00%、24.00%、60.00%、60.00%，均显著高于良性肿块的8.22%、27.40%、5.48%、4.11%、5.48%，均

0.05。在CEUS征象方面，良性肿块主要表现为无/低/等的均匀增强，且为慢/同步增强；恶性肿块主要表现为不均匀的高增强，且为快速增强。ROC曲线显示O-RADS+CEUS诊断卵巢-附件恶性肿块的曲线下面积（area under curve，AUC）大于O-RADS（0.972

0.860，

＜0.05）。与O-RADS相比，O-RADS+CEUS诊断卵巢-附件恶性肿块的灵敏度、特异度、阳性预测值、阴性预测值及准确度明显更高，分别为95.03%、96.78%、92.02%、96.84%和96.17%（

＜0.05）。2名超声科医师对灰阶超声、灰阶超声+CEUS的O-RADS分类结果评估均有较高的一致性（Kappa=0.885、0.871）。

结论：

超声O-RADS分类可较为准确地判定卵巢-附件肿块风险分层，增加CEUS检查可调整O-RADS分级，进一步提高诊断的准确度。

Abstract

Objective:

To explore the application value of contrast-enhanced ultr

asound (CEUS) in adjusting the Ovarian- Adnexal Reporting and Data System (O-RADS) grading for ovarian adnexal masses.

Methods:

A total of 98 patients in Shanghai General Hospital

Shanghai Jiao Tong University School of Medicine with ovarian adnexal masses who underwent two-dimensional ultrasound and CEUS examinations were selected as the study subjects. The two-dimensional ultrasound images were evaluated through O-RADS and CEUS perfusion characteristics were analyzed. With pathological diagnosis as the gold standard

the receiver operating characteristic (ROC) curve was drew

and the diagnostic efficacy of O-RADS and O-RADS+CEUS in ovarian accessory malignant tumors were analyzed.

Results:

The pathological results showed 25 cases of malignant masses and 73 cases of benign masses. The proportion of malignant masses with cyst wall/septal thickness ≥3 cm

solid components

papillary protrusions≥4

blood flow score 3-4

and ascites were 68.00%

80.00%

24.00%

60.00%

and 60.00%

respectively

which were significantly higher than those of benign masses with 8.22%

27.40%

5.48%

4.11%

and 5.48%

all

＜0.05. In terms of CEUS signs

benign masses mainly exhibit uniform enhancement of no/low/equal

and slow/synchronous enhancement; Malignant masses are mainly characterized by uneven high enhancement and rapid enhancement. The ROC curve showed that the area under curve (AUC) value of O-RADS+CEUS in diagnosing ovarian adnexal malignant masses was higher than that of O-RADS (0.972 vs 0.860

＜0.05). Compared with O-RADS

O-RADS+CEUS has significantly higher sensitivity

specificity

positive predictive value

negative predictive value

and accuracy in diagnosing ovarian adnexal malignant masses

and they were 95.03%

96.78%

92.02%

96.84%

and 96.17% respectively (

＜0.05). Two ultrasound physicians had high consistency in evaluating the O-RADS classification results of grayscale ultrasound and grayscale ultrasound+CEUS (Kappa=0.885

0.871).

Conclusion:

Ultrasound O-RADS classification can accurately determine the risk stratification of ovarian adnexal masses. The addition of CEUS can adjust the O-RADS grading

further improving the accuracy of diagnosis.

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