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

P

＜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

P

＜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 (

P

＜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.