The Application Of Three-dimensional Contrast-enhanced Power Doppler Ultrasound And GI-RADS For Characterizing Ovarian Masses

Objective To investigate the diagnostic value of three-dimensional power Doppler with contrast-enhanced(3D-CEPD) ultrasound for differentiating benign and malignant ovarian masses.Methods Fifty patients with ovarian masses were evaluated by three-dimensional power Doppler(3D-PD) ultrasound at three different times: before contrast-enhanced,contrast-enhanced medium and after contrast-enhanced. Using 3D-PD histogram to calculate the three vascular parameters: VI,FI and VFI. The VI,FI and VFI were compared between the benign and malignant tumors. At the same time, the differences of the three vascular parameters were compared between the three different inspection periods.Results Of the 50 cases,18 were confirmed as borderline or malignant through pathologic diagnoses, and 32 were confirmed being benign by follow-up observation or pathologic diagnoses. With three different inspection periods, the vascular parameters of malignant tumors were significantly higher than those of benign tumors(P<0.05).The differences between the vascular parameters of the three different periods were also statistically significant(P<0.05). VI had the most differential diagnostic value because the area under the ROC curve(AUC)s of VI,FI and VFI were VI>VFI>FI(P<0.05). Before contrast-enhanced,the sensitivity,specificity, positive predictive value, negative predictive value and accuracy rate with VI>2.2% as diagnostic criteria of malignant tumors were 77.8% and 87.5%, 77.8%,87.5%, 84%. Contrast-enhanced medium, the diagnostic criteria with VI>23.2% were94.4% and 90.6%, 85%, 96.6%,92%.And after contrast-enhanced, with VI>12.4%,were 94.4% and 93.7%, 89.5%, 96.8%,94%. The diagnostic efficancys in Contrast-enhanced medium and after contrast-enhanced were all better than before contrast-enhanced, and significant difference was discovered(P<0.05).AUCs of VI about the three different periods was 0.829, 0.873 and 0.891 respectively.Conclusion 3D-PD ultrasound with determination of VI, FI, and VFI is a sensitive and specific tool for distinguishing malignant and benign ovarian masses whenever before contrast-enhanced,contrast-enhanced medium or after contrast-enhanced.VI has most diagnostic value in the three vascular parameters. The diagnostic efficiency.of Contrast-enhanced medium or after contrast-enhanced is higher than before contrast-enhanced. 3D-CEPD ultrasound is a more accurate evaluation of the ovarian tumor perfusion, especially after contrast-enhanced. It would be a more effective method for differentiating ovarian malignant tumors.Objective To investigate the value of three-dimensional contrast-enhanced Power Doppler(3D-CEPD) ultrasound and gynecological imaging reporting and data system(GI-RADS) in differentiating ovarian masses.Methods 50 cases of ovarian tumors were diagnosed with GI-RADS and3D-CEPD..And the diagnostic analysis was done with follow-up observation and pathological results to compare between 3D-CEPD ultrasound and GI-RADS in differentiating benign and malignant ovarian tumor on the diagnostic performance differences.Results Of the 50 cases,18 were confirmed as borderline or malignant through pathologic diagnoses, and 32 were confirmed being benign by follow-up observation or pathologic diagnoses. 50 cases of ovarian tumors were diagnosed with GI-RADS, including 25 cases of GI-RADS3, 10 cases of GI-RADS4 and 15 cases of GI-RADS5.If Gl-RADS3 was considered as benign and GI-RADS4-5 as malignant,the diagnostic sensitivity was 94.4% and specificity of 75%,positive predictive value of 68%,the negative predictive value of 96% and the accuracy rate of 82%. And the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of 3D-CEPD ultrasound with VI>12.4% were 94.4%,93.7%,89.5%,96.7% and 94% in diagnosis of benign and malignant ovarian tumors and the diagnostic specificity, the positive predictive value and the negative predictive value is significantly higer than Gl-RADS(P<0.05)?Conclusion Gl-RADS is helpful to the screening of benign and malignant ovarian tumors. And 3D-CEPD is more helpful in identifying the GI-RADS3-5 for ovarian tumors.