Clinical Studies Of Contrast-Enhanced Ultrasound In GI-RADS Reclassification

Objective:To assess the value of contrast-enhannced intravenous ultrasound in Gynaecological Imaging Report And Data System(GI-RADS)reclassifing of adnexal masses.Methods:From July 2019 to December 2020,80 casesadmitted to the hospital due to "adnexal masses"andaccepted operationwith pathological resultsin Chengdu First People’s Hospitalwere included..General conditions of the mass such aslocation,size,shape,boundary,,surroundings etc.were recorded.and also the morphological indicators recommended by the International Ovarian of Tumor Analysis(IOTA),including Large papillary protrusions(≥7mm),cyst wall orseparationthickness central blood flow,abdominal effusion,etc.were focused.The masses were classified by GI-RADS firstly,and the thoseGI-RADS 3 or above were selected to do contrast-enhanced ultrasound(CEUS)examination.According to the results of CEUS,GI-RADSclassfication of the masswere reclassified.Classification,results of two-dimensional and CEUS were compared with pathological results for diagnostic efficiency analysis separatly.Results:Among the 80 cases,68 were benign and 12 cases were malignant.Two-dimensional ultrasonography GI-RADS classified 62 cases in 3 categories,10 cases in 4 categories,and 8 cases in 5 categories.After contrast enhanced ultrasound,65 cases of GI-RADS3,5 cases of 4,and 10 cases of 5 categories were examined.The sensitivity,specificity,accuracy and Youden index of GI-RADS were 83.33%,88.24%,85%and 0.7157 respectively.After contrast-enhanced ultrasound,the sensitivity of GI-RADS reclassification was 91.67%,the specificity was 94.12%,the accuracy was 93.75%,and the Youden index was 0.8579.Conclusion:GI-RADS classification method is simple and easy to operate,which standardizes the writing of complex pelvic masses ultrasonic report,and helps clinicians to interpret ultrasonic results more clearly.Contrast-enhanced ultrasound shows the micro-blood perfusion inside the lesion clearly,which can accurately reclassify the GI-RADS classification of the masses,reduce false negatives of type 3 and some false positives of type 4,and further improve the diagnostic efficiency of adnexal masses.