标题：O-RADS分类对卵巢附件肿块良恶性的诊断效能研究

      作者：刘月媚，李丽娟，陈静，袁领欢，罗海波    南方医科大学附属东莞医院超声科，广东 东莞 523000

      卷次： 2022年33卷15期

      【摘要】 目的 探讨卵巢-附件影像报告和数据系统(O-RADS)分类对卵巢附件肿块良恶性的诊断效能，为患者的临床诊疗提供相关指导。方法 回顾性分析 2019年 1月至 2021年 1月于南方医科大学附属东莞医院行超声检查并经病理证实的 50例卵巢附件肿块患者的超声图像，对图像特征进行O-RADS分类，以病理结果为金标准。分析O-RADS各分类的卵巢附件肿块恶性率及不同医师对O-RADS分类的诊断一致性，并采用受试者工作特征曲线(ROC)分析O-RADS对卵巢附件肿块良恶性的诊断效能。结果 O-RADS2、3、4、5各分类的卵巢附件肿块恶性率分别为 0、6.25%、25.00%、68.75%；O-RADS3类的卵巢附件肿块良性率为 35.29%，明显高于恶性率(6.25%)，O-RADS5类的卵巢附件肿块恶性率为68.75%，明显高于良性率(14.71%)，差异均有统计学意义(P<0.05)；不同医师对O-RADS分类的诊断具有较高的一致性，Kappa值为0.839，P<0.001；O-RADS诊断卵巢附件肿块恶性的曲线下面积(AUC)为0.858，其诊断的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为78.00%、86.00%、80.00%、76.00%、90.00%。结论 O-RADS对卵巢附件肿块良恶性有一定的诊断效能，临床诊断的敏感度、特异度及准确度均较高，值得推广。
      【关键词】 卵巢；附件；肿块；影像报告和数据系统；诊断效能
      【中图分类号】 R737.31 【文献标识码】 A 【文章编号】 1003—6350（2022）15—1991—04

Diagnostic efficacy of O-RADS classification for benign and malignant ovarian adnexal masses.
LIU Yue-mei, LILi-juan, CHEN Jing, YUAN Ling-huan, LUO Hai-bo. Department of Ultrasound, Dongguan Hospital Affiliated to SouthernMedical University, Dongguan 523000, Guangdong, CHINA
【Abstract】 Objective To explore the diagnostic efficacy of O-RADS classification for benign and malignant ovari-an adnexal masses, and to provide relevant guidance for the clinical diagnosis and treatment of patients.Methods The ultra-sonic images of 50 patients with ovarian adnexal masses who underwent ultrasound examination and were pathologically con-firmed in Dongguan Hospital Affiliated to Southern Medical University from January 2019 to January 2021 were retrospec-tively analyzed. The image features were classified by O-RADS, and the pathological results were taken as the gold standard.The malignancy rate of ovarian adnexal masses classified by O-RADS and the diagnostic consistency of O-RADS classi-fication by different physicians were analyzed, and the receiver operating characteristic curve (ROC) was used to ana-lyze the diagnostic efficacy of O-RADS in benign and malignant ovarian adnexal masses. Results The malignant ratesof ovarian adnexal masses in O-RADS 2, 3, 4, and 5 categories were 0, 6.25%, 25.00%, and 68.75%, respectively; the be-nign rate of ovarian adnexal masses of O-RADS 3 type was 35.29%, which was significantly higher than 6.25% of themalignant rate; the malignant rate of ovarian adnexal masses of O-RADS 5 type was 68.75%, which was significantlyhigher than 14.71% of the benign rate; the differences were statistically significant (P<0.05). The diagnosis of O-RADSclassification by different physicians had a high consistency, and Kappa value was 0.839, P<0.001. The area under thecurve (AUC) of O-RADS in the diagnosis of malignant ovarian adnexal masses was 0.858, and the sensitivity, specifici-ty, accuracy, positive predictive value, and negative predictive value of the diagnosis were 78.00%, 86.00%, 80.00%,76.00%, and 90.00%, respectively. Conclusion O-RADS has certain diagnostic efficacy for benign and malignant ovari-an adnexal masses, and its sensitivity, specificity and accuracy are high in clinical diagnosis, which is worthy of promotion.
      【Key words】 Ovary; Attachment; Mass; Image Reporting and Data Systems; Diagnostic performance