The Value Of IOTA Simple Rules Combined With Contrast-enhanced Ultrasound In The Diagnosis Of Adnexal Masses

Objective: To explore the diagnostic value of IOTA simple rules combined with contrast-enhanced ultrasound in the diagnosis of adnexal masses.Methods:A total of 129 continuous adnexal masses were selected,IOTA simple rules and contrast-enhanced ultrasound diagnostic criteria were used for diagnostic tests to analyze the advantages and disadvantages of its differential diagnosis of benign and malignant adnexal masses.The second step is to establish the diagnostic criteria of IOTA simple rules combined with contrast-enhanced ultrasound,pathological results and long-term follow-up results were used as the gold standard to analyze and evaluate the value of various methods in the diagnosis for the adnexal mass.Results:(1)25 masses were unsuitable for the simple rules,diagnosed as uncertain,accounting for 19.4% of the total cases.The sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio,coincidence rate and the area under the ROC curve,95% confidence interval of IOTA simple rules are 91.42%、91.30%、84.21%、95.45% 、 10.51 、 0.09 、 91.35% 、 0.914(0.847-0.980).(2)The above indicators of contrast-enhanced ultrasound are 94.59%、94.56%、87.50%、97.75%、17.39、0.06、94.57%、0.946(0.896-0.996).Draw the ROC curve of the contrast-enhanced ultrasound score,When the area under the ROC curve is the largest,the cut-off value is 13.5 points.Therefore,14 points are used as the best diagnostic cut-off point.When the angiography score is ≥ 14,it is judged as malignant,with rich blood flow characteristics.(3)The sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio,coincidence rate and the area under the ROC curve,95% confidence interval of simple rules combined with contrast-enhanced ultrasound are 97.29%、95.65%、90.00%、98.88%、22.37、0.03、96.12%,0.940(0.926-1.000),Compared with the previous two single diagnosis methods,simple rules combined with contrast-enhanced ultrasound has the largest area under the ROC curve,the diagnostic performance was the best and the sensitivity and specificity were improved.Conclusions:IOTA simple rules combined with contrast-enhanced ultrasound has high diagnostic value and improved accuracy in judging benign and malignant masses in the adnexal masses,which can make up for the limitation that some cases cannot be diagnosed by simple rules,which provide a strong basis for the clinical diagnosis of adnexal masses.