Contrast-enhanced Ultrasound In The Small Solid Anexal Masses Application Of The Differential Diagnosis

Objective:To explore the value of Contrast-Enhanced Ultrasound(CEUS) in the differential diagnosis of small solid adnexal masses(≤4cm).Methods:A total of sixty-nine patients who were treated in the first affiliated hospital of XinJiang Medical University from August2009to February2013were slected as study subjects, seventy small(≤4cm) adnexal masses were found by transabdominal or transvaginal sonography,the masses showed low/medium/high echo on the two-dimensional ultrasound imaging,or mixed echoes with mainly solid echo.All of70solid adnexal masses were examined by CEUS,a new CEUS scoring system was developed according to the characteristics of solid adnexal masses.Results of CEUS were compared with surgical pathology and long-term follow-up results so as to evaluate the CEUS scoring system.Results:There were51benign masses and19malignant masses among fifty-nine small adnexal masses.There were significant differences in perfusion pattern, vascular morphology,perfusion intensity,curve shape and peak score between benign masses and malignant masses’scores(P<0.05). The area under the ROC curve was0.988maximally, and the cut-off score was14(>14was malignant).The sensitivity, specificity, accuracy, positive predictive value,negative predictive value,positive likelihood ratio,nagtive likelihood ratio,fitness rate and Kappa value of CEUS scoring system in the differential diagnosis of small solid adnexal masses(benign and malignant) was94.74%,96.08%,90.00%,98.00%,24.16,0.06,95.71%,0.89respectively.There were significant differences in perfusion pattern,vascular morphology,perfusion intensity,curve shape,arrive time, peak score and regional blood flow(P<0.05),not in peak time,regional blood volume, and mean transit time (P≥0.05) between benign masses and malignant masses’ characteristics.Conclusion:The CEUS scoring system can accurately tell the difference between benign and malignant,which may contribute to diagnose malignant adnex tumor early.