Clinical significance of transvaginal color Doppler ultrasound for the differential diagnosis of benign and malignant ovarian cysts / 中国辐射卫生

ABSTRACT

@#<b>Objective</b> To evaluate the clinical significance of transvaginal color Doppler ultrasound for the differential diagnosis of benign and malignant ovarian cysts. <b>Methods</b> Patients who were diagnosed with clinically suspected or palpable adnexal masses and underwent gray-scale ultrasonography, transvaginal color Doppler ultrasonography, and ultrasound-guided fine-needle aspiration cytology (FNAC) during the period from 2018 to 2021 were enrolled in this study. The pulsatility index (<i>PI</i>) and resistance index (<i>RI</i>) were estimated, and an ovarian cyst with the lowest <i>PI</i> value of < 1.0 or the lowest <i>RI</i> value of < 0.4 was considered as malignant. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of gray-scale ultrasound and transvaginal color Doppler ultrasound for the differential diagnosis of benign and malignant ovarian cysts were estimated with FNAC as the gold standard. <b>Results</b> A total of 180 patients with ovarian cysts were recruited, and FNAC revealed that 81 of them had malignant lesions and 99 of them had benign lesions. The transvaginal color Doppler ultrasonograms showed that 75 patients (92.59%) with malignant lesions had blood-flow signals in their cysts and 42 patients (42.24%) with benign lesions had blood-flow signals in their cysts, with a significant difference in the proportion between the two groups (<i>χ</i>² = 49.29, <i>P</i> < 0.01). Among the 75 patients with blood-flow signals in malignant ovarian cysts, 75 had <i>PI</i> < 1.0 and 24 had <i>RI</i> < 0.4; among the 42 patients with blood-flow signals in benign ovarian cysts, 15 had <i>PI</i> < 1.0 and no one had <i>RI</i> < 0.4; there were significant differences in the proportions of <i>PI</i> < 1.0 and <i>RI</i> < 0.4 between the two groups (<i>χ</i>² = 62.68, <i>P</i> < 0.01; <i>χ</i>² = 16.91, <i>P</i> < 0.01). In addition, compared with the combination of gray-scale ultrasound and transvaginal color Doppler ultrasound, gray-scale ultrasound alone had significantly lower sensitivity (51.85% <i>vs</i> 81.48%; <i>χ</i>² = 16.00, <i>P</i> < 0.01), specificity (75.76% <i>vs</i> 93.94%; <i>χ</i>² = 12.73, <i>P</i> < 0.01), PPV (63.64% <i>vs</i> 91.67%; <i>χ</i>² = 15.90, <i>P</i> < 0.01), and NPV (65.79% <i>vs</i> 86.11%; <i>χ</i>² = 12.44, <i>P</i> < 0.01) for the differential diagnosis of benign and malignant ovarian cysts. <b>Conclusion</b> Gray-scale ultrasound is effective for diagnosing ovarian cysts; however, gray-scale ultrasound combined with transvaginal color Doppler ultrasound can improve the differential diagnosis of benign and malignant ovarian cysts.