Application values of four risk of malignancy indices in the preoperative evaluation of patients with adnexal masses / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the diagnostic values of four risk of malignancy indices (RMI) for malignant adnexal masses.</p><p><b>METHODS</b>The data of 223 women with adnexal masses admitted to the Department of Obstetrics and Gynecology of Peking Union Medical College Hospital for surgical exploration between June 2008 and December 2008 were retrospectively analyzed. The sensitivity, specificity, positive predictive value and negative predictive value of RMI1, RMI2, RMI3, and RMI4 in the diagnosis of malignant adnexal masses were calculated.</p><p><b>RESULTS</b>When the cutoff levels of RMI1, RMI2, RMI3 were set at 200 and RMI4 at 450, the sensitivities for diagnosing malignant adnexal masses ranged 59.0%-67.2%, the specificities ranged 94.4%-96.9 %, the positive predictive values ranged 82.0%-87.8%, and the negative predictive values ranged 90.9%-92.6%. The Youdens indexes (YI) of RMI1, RMI2, RMI3, and RMI4 were 0.559,0.606,0.576, and 0.559, respectively. RMI2 was significantly different from RMI1 (P=0.000), RMI3 (P=0.008), and RMI4 (P=0.000) in terms of diagnostic efficiency. RMI1, RMI2, RMI3, and RMI4 at a cutoff level of 75.688.679.1, 177.2 respectively, according to ROC curves, yielded sensitivities of 77.8%-82.5%, specificities of 84.6%-90.1%, positive predictive values of 69.0%-75.4%, and negative predictive values of 90.9%-92.6%; the relevant YI of RMI1, RMI2, RMI3, and RMI4 were 0.635, 0.665, 0.651 and 0.705, respectively. Under this cutoff level, the difference between RMI1, RMI2, RMI3, and RMI4 in diagnosing malignancy had no statistic significant. The primary histological types arising false negative were early stage epithelial ovarian cancer and non-epithelial ovarian cancer. The primary histological types arising false positive were endometriosis masses and degenerative sex cord-stromal tumor.</p><p><b>CONCLUSIONS</b>RMIs are useful indices for the differentiation between benign and malignant pelvic diseases. Meanwhile, their cutoff levels for Chinese populations need further study.</p>

Sonographic and computed tomography features of hepatic angiomyolipoma / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the sonographic and computed tomography (CT) features of hepatic angiomyolipoma (HAML).</p><p><b>METHODS</b>Sonographic and CT findings were analyzed in 12 patients (9 females and 3 males) with pathologically proved HAML. The size, margin, location, gray scale, and color Doppler flow imaging characteristics were observed.</p><p><b>RESULTS</b>HAML was located correctly with ultrasound in all patients. The sonographic features of 12 HAML included regular shape, clear margin, and three type of echoes including homogeneous hyperechoes (n=5), heterogeneous internal echoes (n=5), or homogeneous hypoechoes (n=2). The arterial flow signal was detected in two HAML. The CT findings included adipose density (n=3), soft tissue density (n=3), and mixed density (n=6). The sonographic and CT findings were correlated with the composition and distribution of fat, vessels, and smooth muscle tissue.</p><p><b>CONCLUSIONS</b>Fatty tissues within HAML shows typical imaging findings. The ultrasonographic and CT have their own advantages in detecting the fatty tissue inside HAML, and therefore a combination of these two techniques may increase the diagnostic accuracy of HAML.</p>