影像技术

目的：前瞻性探究基于2020年美国放射学会（ACR）O-RADS超声分类标准，联合血清CA125、HE4评估卵巢—附件肿瘤良恶性的临床价值。方法：选取2024年本院163名患者（共183例肿瘤，20例为双侧肿瘤，143例为单侧肿瘤），术前以经阴道超声为主（必要时结合经腹部超声）进行O-RADS分类，检测血清CA125、HE4水平，以术后病理为金标准分析诊断效能。结果：183例肿瘤中良性肿瘤136例，恶性肿瘤47例。O-RADS单独诊断AUC为0.936(95%CI:88.6%～98.6%)，灵敏度89.4%，特异度91.2%;CA125单独诊断AUC为0.740(95%CI:65.7%～82.3%)，灵敏度76.6%，特异度71.3%;HE4单独诊断AUC为0.709(95%CI:61.1%～80.8%)，灵敏度42.6%，特异度99.3%；三者联合时AUC为0.949(95%CI:90.3%～99.6%)，灵敏度91.5%，特异度90.4%。结论：O-RADS单独或联合血清CA125、HE4对卵巢—附件肿瘤良恶性诊断效能高，具有临床推广价值。

Objective: To investigate the clinical value of the 2020 American College of Radiology(ACR) ovarian-adnexal reporting and data system(O-RADS) ultrasound classification criteria in conjunction with serum CA125 and HE4 for discriminating benign from malignant ovarian-adnexal tumors. Methods: A total of 163 patients(with 183 tumors in total, including 20 cases of bilateral tumors and 143 cases of unilateral tumors) admitted to our hospital in 2024 were selected. Preoperative O-RADS classification was performed mainly using transvaginal ultrasound(with transabdominal ultrasound combined if necessary). The serum levels of CA125 and HE4 were detected, and the diagnostic efficacy was analyzed with postoperative pathology as the gold standard. Results: Among the 183 tumors, 136 were benign and 47 were malignant. For O-RADS alone, the area under the curve(AUC) was 0.936(95% CI: 88.6%～98.6%),with a sensitivity of 89.4% and a specificity of 91.2%. For CA125 alone, the AUC was 0.740(95%CI:65.7%～82.3%), with a sensitivity of 76.6% and a specificity of 71.3%.For HE4 alone, the AUC was 0.709(95%CI: 61.1%～80.8%), with a sensitivity of 42.6% and a specificity of 99.3%.When the three were combined, the AUC was 0.949(95% CI: 90.3%～99.6%), with a sensitivity of 91.5% and a specificity of 90.4%.Conclusion: O-RADS alone or combined with serum CA125 and HE4 has high diagnostic efficacy in distinguishing benign from malignant ovarian-adnexal tumors, and thus has clinical promotion value.