Diagnostic Value Of O-RADS Classification Combined With Contrast-enhanced Ultrasound In Differentiating Benign And Malignant Ovarian Adnexal Masses

Objective To evaluate the diagnostic value of O-RADS classification combined with contrast-enhanced ultrasound in differentiating benign and malignant ovarian adnexal masses.Methods From January 2019 to December 2021,49 patients with ovarian adnexal masses admitted to Wenzhou People’s Hospital were selected for routine ultrasound examination in our hospital,All patients had postoperative pathological results and follow-up results.They were all received color Doppler ultrasound and contrast-enhanced ultrasound before operation.The results were classified and diagnosed by senior doctors according to the consensus guidelines for O-RADS ultrasound risk stratification and management proposed by the American Academy of Radiology(ACR).Take pathological results as the gold standard,calculating the qualitative diagnostic efficacy of O-RADS classification and contrast-enhanced ultrasound and O-RADS classification combined with contrast-enhanced ultrasound for benign and malignant ovarian adnexal masses.Select semi-quantitative grading comparison of color Doppler ultrasound blood flow distribution and parameters related to contrast-enhanced ultrasound.ROC curve analysis was used to evaluate the quantitative diagnostic ability of each parameter index in the differentiation of benign and malignant ovarian adnexal masses.Results 1.The O-RADS classification and evaluation results among doctors with different eniority have good consistency.2.The detection rate of malignant lesions by O-RADS classification was consistent with the malignant risk of each O-RADS classification in the guidelines.3.O-RADS classification had statistical significance in qualitative diagnosis of benign and malignant ovarian adnexal masses compared with pathological results.4.The results of contrast-enhanced ultrasound were statistically significant in the qualitative diagnosis of benign and malignant ovarian adnexal masses compared with the pathological results.5.There was statistical significance in the comparison of ultrasound O-RADS classification combined with contrast-enhanced ultrasound diagnosis and pathological results.6.Comparison of diagnostic efficacy of three detection methods:"O-RADS classification","contrast-enhanced ultrasound" and "O-RADS classification combined with contrast-enhanced ultrasound diagnosis results".O-RADS classification combined with contrast-enhanced ultrasound has the highest diagnostic efficiency,with sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 71.4%,100%,100%,89.7%and 91.8%,respectively.The area under the O-RADS classification curve is 0.886,the area under the contrast-enhanced ultrasound curve is 0.899,and the area under the combined curve of the two is the highest,0.936.7.There was statistically significant difference in the semi-quantitative grading of blood flow distribution of benign and malignant adnexal masses by color Doppler ultrasound.8.There was statistical significance in the comparison of parameters related to the contrast-enhanced ultrasound curve between the benign and malignant adnexal masses.9.Among the parameters related to the time-intensity curve of contrast-enhanced ultrasound,AT value in benign group is higher than that in malignant group and higher than that in myometrium group,TTP value in benign group is higher than that in malignant group and higher than that in myometrium group,PI value in benign group is smaller than that in myometrium group and smaller than that in malignant group,AUC value in benign group is smaller than that in myometrium group and smaller than that in malignant group,p value was less than 0.05,the difference was statistically significant.10.ROC curve analysis result display,Color Doppler ultrasound score and relevant parameters of contrast-enhanced ultrasound curve have certain value in quantitative diagnosis of benign and malignant ovarian adnexal masses,the quantitative diagnostic value of PI and AUC is relatively high.The area under the curve is 0.941 and 0.826 respectively.The risk cutoff values are AT 19.487s(Yoden index 0.564),TTP 28.564s(Yoden index 0.592),PI 23.5dB(Yoden index 0.823),AUC 1804dB.s(Yoden index 0.672).Conclusion Ultrasound O-RADS classification has good clinical value in the diagnosis of benign and malignant ovarian adnexal masses.Contrast-enhanced ultrasound has certain qualitative and quantitative diagnostic value in differentiating benign and malignant ovarian adnexal masses.The combination of the two can further improve the diagnostic efficiency and provide more basis for further treatment and surgery.