The Value Of Ovarian-Adnexal Reporting And Data System (O-RADS) Combined With Contrast-enhanced Ultrasound In The Diagnosis Of Ovarian Adnexal Tumors

Objective: To assess the effectiveness of contrast-enhanced ultrasonography and the Ovarian-Adnexal Reporting and Data System(O-RADS)in identifying benign from malignant ovarian-adnexal tumors.Methods: 93 cases with ovarian-adnexal masses found by ultrasound were selected to collect basic information of age,menstrual history,and menopause or not(1 year without menstruation was defined as menopause).Query the medical record system to record the relevant laboratory examination results of the patient,and record the value of the tumor marker sugar antigen 125(carbohydrate antigen 125,CA-125).O-RADS classification,CEUS and the combination of the two were used to evaluate the benign and malignant ovarian-adnexal masses,evaluation and comparison of the three diagnostic approaches for benign and malignant ovarian adnexal masses were done using biopsy or surgical pathology as the gold standard.Results:1.There were 93 cases of ovarian-adnexal tumors,32 of which were benign and 61 of which were malignant.The biggest tumor diameter in the benign group measured(86.56±41.86)mm,whereas the maximum tumor diameter in the malignant group measured(90.30±50.68)mm;The average age of the benign group was(52.69±16.79)years old,whereas the average age of malignant group was(57.51±9.16)years old.2.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 93 masses,were 96.72%,71.88%,88.17%,86.76% and 92.00% respectively.According to the O-RADS score,category 4 was taken as cutoff point between benign and malignant ovarian-adnexal tumors,the maximum area under the ROC curve was0.843.3.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of contrast-enhanced ultrasound in the diagnosis of benign from malignant tumors of ovary and adnexa were 93.44%,81.25%,89.25%,90.48% and 86.67%respectively,the maximum area under the ROC curve was 0.873.The score of contrast-enhanced ultrasound for ovarian-adnexal masses had statistical differences between the two groups.4.Using O-RADS category and CEUS,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ovarian-adnexal masses were 98.36%,84.38%,93.55%,92.31% and 96.43% respectively,the maximum area under the ROC curve was 0.914.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of O-RADS category combined with contrast-enhanced ultrasound have been improved compared with single diagnostic method.Conclusions:1.O-RADS has great clinical value in differentiating benign from malignant ovarian-adnexal masses,while the diagnostic efficacy of O-RADS 4 is the highest;2.CEUS can make up for the deficiency of two-dimensional ultrasound to some extent,and has certain significance in the difficult diagnosis of ovarian masses and the observation of microflow perfusion of masses,provide more accurate diagnosis of benign and malignant,and improve the diagnostic efficiency of ovarian tumors;3.O-RADS classification combined with CEUS can provide can provide more accurate classification and differentiation information for the clinical diagnosis of benign and malignant ovarian-accessory masses,improve the detection rate of ovarian malignant tumors more effectively,and have important significance for the early diagnosis and differentiation of ovarian cancer.