| ObjectivesThe purpose of this study was to evaluate the efficacy of the combination of Gynecologic Imaging Reporting and Data System(GI-RADS)ultrasonographic stratithfication and 3-dimensional contrast-enhanced ultrasonography(3D-CEUS)score in discriminating between benign and malignant ovarian masses.Methods102 patients were chosen to accepted 3D-CEUS and then Comparing the ultrasonographic results with follow-up observation or pathologic diagnoses.A total of ten signs,including six signs suggested by GI-RADS and four signs by 3D-CEUS were analyzed through single factor and multiple factor Logistic regression analysis to screen the valuable signs as the score system of GI-RADS combination with 3D-CEUS score.At the same time,the consistency and diagnostic test were also conducted.Results(1)Single factor and diagnostic test showed that ten signs were all statistically significant(P<0.05)and had good diagnostic value in differential ovarian tumors,however,multiple factor Logistic regression analysis confirmed that there were only 8 independent predictors of malignant masses,including large papillary projections(more than 7mm),separated/wall thickness,Central blood flow,ascites,solid lesions(cystic part of <50%),contrast-enhanced level,the distribution of contrast agent in enhanced solid part and the vascular characteristics of solid part and their odds ratios were 5.391,5.521,5.924,4.348,4.943,7.443,6.096 and 7.672 respectively(P < 0.05).(2)Eight signs were used as the evaluation system of GI-RADS combination with 3D-CEUS score with 4 points as the cut-off point for diagnosis of benign or malignant had better performance than using GI-RADSlonely and the diagnostic sensitivity,specificity,the positive predictive value,negative predictive value and accuracy were 94.3% VS 80.8%,95.5% VS 88.6%,91.7% VS 77.7%,96.7% VS 89.4%,95.1% VS 85.3%(P<0.05).The AUC value of GI-RADS combination with 3D-CEUS score was 0.969 and was superior than using GI-RADS lonely which the AUC value was 0.839(Z value=1.64,P<0.025).(3)The Kappa test showed there was a significant consistent between two different clinicians with equal experience.Conclusions GI-RADS combination with 3D-CEUS score would be a more effectively preliminary screening to distinguish malignant from benign in ovarian masses.Objectives The purpose of this study was to explore the clinical value of combination of Gynecologic Imaging Reporting and Data System(GI-RADS)ultrasonographic stratification and 3-dimensional contrast-enhanced ultrasonography(3D-CEUS)score in predicting biological behavior of ovarian tumors by analyzing its correlation with prognostic factors and evaluating ovarian tumor angiogenesis by estimating its prognostic factors expression correlation with microvessle-density(MVD).Methods 56 patients were chosen to accepted with 3D-CEUS and their ultrasonographic findings were compared with the pathological results.MVD,estrogen receptor(ER),progesterone receptor(PR),tumor protein 53(Tp53)expression were measured by immunohistochemistry.Results(1)Pathological results showed 36 benign and 20 malignant ovarian tumors including two borderline ovarian tumors.GI-RADS combination with 3D-CEUS score with 4 points as the cut-off point for diagnosis of benign and malignant had good performance and the diagnostic sensitivity,specificity and accuracy were 90%,94.4%,92.9% respectively.The AUC value of GI-RADS combination with 3D-CEUS was 0.961.(2)The GI-RADS combination with 3D-CEUS score was correlated well with ER(r=0.69,P<0.001),PR(r=0.63,P<0.001),Tp53(r=0.61,P<0.001),MVD(r=0.73,P<0.001).(3)The MVD were correlated well with ER(r=0.71,P<0.001),PR(r=0.70,P<0.001),Tp53(r=0.73,P<0.001).Conclusions GI-RADS combination with 3D-CEUS score is correlated well with ER,PR,Tp53 expression,thus have great potential in predicting biological behavior of ovarian tumors.Furthermore,they also is correlated well with MVD,so it could be used to angiogenesis evaluation in ovarian tumor. |
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