| Objective: To investigate the application value of ultrasound IOTA simple rules in the diagnosis of adnexal masses.Methods: A total of 463 patients with adnexal masses were classified into benign mass, malignant mass and uncertain mass according to IOTA simple rules by doctor A and B(junior and senior doctors with 5 and above 20 years of work experience in gynecological ultrasound, respectively) using color Doppler flow imaging. The doctors were blind to the examination results and operation results. The classification results whether the masses were benign or malignant was judged according to IOTA simple rules were compared with pathological results for diagnostic analysis.Results:(1) Among the 463 cases, 411 cases were benign mass and malignant mass(88.77%) and 52 cases were uncertain mass(11.23%).(2) The judgment results of doctor A and B were as follows: benign mass 360(77.75%) and 362(78.19%), malignant mass 51(11.02%) and 49(10.59%), diagnostic sensitivity 85.71% and 90.48%(χ2=0.50,P=0.500), specificity 95.93% and 97.02%(χ2=2.25,P=0.125), positive predictive value 70.59% and 77.56%(χ2=0.63,P=0.427), and negative predictive value 98.34% and 98.90%(χ2=0.107,P=0.743); diagnostic coincidence rate 94.9% and 96.4%.Conclusion:(1) IOTA simple rules are not suitable for diagnosis of all adnexal masses, and its suitable rate is about 88%.(2) IOTA simple rules is highly sensitive and specific in diagnosis of benign and malignant adnexal masses. There was no significant difference in diagnostic performance among doctors with different experience, it is with great clinical value.Objective: To investigate the application value of ultrasound GI-RADS classification in the diagnosis of adnexal masses.Methods: A total of 514 patients with adnexal masses were classified into 5 class, according to GI-RADS classification by doctor A and doctor B both were blind to examination and operation results(doctor A was junior doctor with 5 years of work experience in gynecological ultrasound; doctor B was senior doctor with above 20 years of work experience in gynecological ultrasound) using color Doppler flow imaging: class 1: confirmed as benign; class 2: very probably benign; class 3: probably benign; class 4: suspected as malignant; class 5: very probably malignant. Results of GI-RADS class 2-5 cases were compared with postoperative pathological results for diagnostic analysis. GI-RADS class 1-4 lesions were classified as benign masses, and GI-RADS class 5 lesions were classified as malignant masses, defined as GI-RADS-1; GI-RADS class 1-3 lesions were classified as benign masses, and GIRADS class 4-5 lesions were classified as malignant masses, defined as GI-RADS-2.Results:(1) Among all the 514 cases, 463 cases of adnexal masses were detected, and the detection rate was 90.08%.(2) In GI-RADS-1, the judgment results of doctor A and B were as follows: benign mass 404(78.6%) and 445(86.58%), malignant mass 110(21.4%) and 69(13.42%), diagnostic sensitivity 60.38% and 73.58%(χ2=5.14,P= 0.016), specificity 83.08% and 93.49%(χ2=48.00,P=0.000), positive predictive value 29.09% and 6.52%(χ2=13.332,P=0.000), and negative predictive value 94.80% and 96.85%(χ2=2.256,P=0.133); diagnostic coincidence rate 94.9% and 96.4%. In GIRADS-2, the judgment results of doctor A and B were as follows: benign mass 383(74.51%) and 426(82.88%), malignant mass 131(25.49%) and 88(17.12%), diagnostic sensitivity 84.91% and 92.45%(χ2=2.25,P=0.125), specificity 81.34% and 91.54%(χ2=37.026,P=0.000), positive predictive value 34.35% and 55.68%(χ2= 9.776,P=0.000), and negative predictive value 97.91% and 99.06%(χ2=1.825,P= 0.177); diagnostic coincidence rate 81.7% and 91.6%.(3) In GI-RADS-1 and GIRADS-2, the diagnostic sensitivity 73.58% and 92.45%(χ2=8.306,P=0.004); specificity 93.49% and 91.54%(χ2=334.682,P=0.000).Conclusion:(1) GI-RADS classification system is suitable for the diagnosis of all benign and malignant adnexal masses including normal adnexa.(2) GI-RADS classification system has highly diagnostic sensitivity and specificity. Diagnosis was different between junior and experienced doctor, and the later usually have better diagnostic performance.(4) GI-RADS-2 has better diagnostic performance than GIRADS-1, it is with great clinical value.Objective: To investigate the comparism of adnexal masses and GI-RADS classification in ultrasound IOTA simple rules,Methods: A total of 411 patients with adnexal masses could be judged by IOTA simple rules in section 1 were selected. Doctors with above 20 years of work experience in gynecological ultrasound(senior doctor) judged the masses benign or malignant by GIRADS-2 classification(the results of IOTA have done in part one). The classification results of IOTA and GI-RADS-2 were compared to pathological results respectively in diagnostic analysis.Results:(1) The judgment results of IOTA simple rules and GI-RADS-2 classification were as follows: benign mass 362(88.08%) and 358(87.10%); malignant mass 49(11.92%) and 53(12.90%); diagnostic sensitivity 90.48% and 97.62%(χ2=1.333,P= 0.250); specificity 97.02% and 96.77%(χ2=0.000,P=1.000); positive predictive value 77.55% and 77.36%(χ2=0.001,P=0.981); and negative predictive value 98.9% and 99.72%(χ2=0.783,P=0.376);diagnostic coincidence rate 96.4% and 96.8%.(2) GIRADS classification was suitable for all adnexal masses including normal adnexal, while IOTA simple rules were only suitable for part of adnexal masses(the suitable range have expressed by part one).Conclusion:(1) IOTA simple rules and GI-RADS classification have highly diagnostic sensitivity and specificity,and no significant difference.(2) GI-RADS classification has a wider range of application compared with IOTA, it is with great clinical value. |
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