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Background: Ovarian masses are common gynecological diseases which may appear and develop in any age group. Despite low prevalence rates, ovarian cancers still have a poor prognosis with high mortality rates, which can be effectively treated in the case of early detection and diagnosis. Methods: A total of 368 cases with ovarian masses treated from January 2016 to December 2017 were selected. These patients were diagnosed again by junior and senior blinded physicians using International Ovarian of Tumor Analysis simple rules (IOTA-SRs) and Gynecologic Imaging Reporting and Data System (Gi-Rads) respectively. Then the diagnostic efficiencies of 2 combined methods and individual ones were compared. Results: For the diagnosis of 368 patients, there were no significant differences between the sensitivity, PPV, NPV and DAR using IOTA-SRs and Gi-Rads by junior and senior physicians (p>0.05). Combining the 2 methods, it boosted the diagnostic performance, with the sensitivity, specificity, and DAR increasing to 96.3%, 92.31%, and 93.48% respectively. The sensitivity and NPV were significantly different (p=0.021, 0.032, p<0.05). Conclusion: Both IOTA-SRs and Gi-Rads had higher diagnostic performance and lower dependence on clinical experience. Combining the 2 methods may enhance the diagnostic performance, especially the sensitivity and NPV. Therefore, it is worthwhile to combine IOTA-SRs with Gi-Rads in the standardization and implementation of public reporting mechanism and the promotion of accurate pre-procedural stratification.
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Objective To investigate the application value of contrast-enhanced ultrasound in the diagnosis of ovarian masses.Methods Ninety-four patients with ovarian masses were observed and undetermined by conventional ultrasound examinations who were underwent contrast-enhanced ultrasound examinations and were made the time-intensity curve.By analyzing the perfusion characteristics and the quantitative parameters of time-intensity curve,we compared the difference of different masses.Results The perfusion characteristics and the quantitative parameters of the time-intensity curve were different.The arrival time and the time to peak intensity of benign masses were later than those of malignant tumors.The peak iniensity of benign masses was lower than that of malignant tumors.There was a significant difference between the two groups.The arrival time and the time to peak intensity of benign tumors were later than those of malignant tumors.The peak intensity of benign tumors was lower than that of malignant tumors.There was a significant difference between the two groups.The time to peak intensity of non-tumorous lesions was later than that of malignant tumors.The peak intensity of non-tumorous lesions was lower than that of malignant tumors.There was a significant difference between the two groups.The arrival time of non-tumorous lesions was earlier than that of benign tumors.There was a significant difference between the two groups.Conclusion The perfusion characteristics and the quantitative parameters that draw from the time-intensity curve of different masses are different.Contrast-enhanced ultrasound is contributive to the diagnosis and the differential diagnosis of different masses.Contrast-enhanced ultrasound also has great clinical values to those ovarian masses whose ultrasonic appearance is complex and difficult to diagnose qualitatively.
ABSTRACT
PURPOSE: The aim of this study was to evaluate the usefulness of four Risk-of-Malignancy Indices (RMI) in women with ovarian masses. MATERIALS AND METHODS: Between January 2007 and December 2008, 344 women who visited our hospital for surgical exploration due to an ovarian mass were enrolled in this study. Each RMI was based on the combination of menopausal status, ultrasound findings of ovarian masses, and absolute level of serum CA-125. A cutoff level of 200 was chosen as the threshold for determining between malignant and benign ovarian masses in RMI 1, RMI 2, and RMI 3. A cutoff level of 450 was chosen as the threshold in RMI 4. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. RESULTS: The combination of four malignancy indices is more accurate than menopausal status, ultrasound findings, and serum CA-125 alone, respectively for determining whether a mass is benign or malignant. RMI 1 and RMI 4 were found to be better than RMI 2 and RMI 3. RMI 4 was the most reliable test among them. The relationship between RMI 1 and RMI 4 was not statistically significant. With the cutoff level for RMI 4 at 450, the corresponding, sensitivity, specificity, positive predictive value, and negative predictive value were 72.1%, 88.0%, 56.4%, 93.9%, respectively. CONCLUSION: All four RMI were reliable tests for determining whether ovarian masses are malignant or benign, and RMI 4 was the most reliable index among them.