中国临床医学影像杂志2025，Vol.36Issue(6)：437-441,5.DOI:10.12117/jccmi.2025.06.013
DWI对卵巢-附件影像报告和数据系统(O-RADS)MRI评分的附加价值
Added value of DWI imaging in the ovarian-adnexal reporting and data system(O-RADS)MRI score
摘要
Abstract
Objective:To investigate the additional value of DWI in the ovarian-adnexal reporting and data system(O-RADS)MRI score for the diagnosis of adnexal masses.Methods:A retrospective analysis was conducted on 76 patients(90 lesions)with adnexal masses who underwent pelvic non-contrast and contrast-enhanced MRI at our institution between January 2018 and December 2023.All lesions were pathologically confirmed,with borderline and malignant lesions classified as malignant.Two radiologists independently performed O-RADS MRI scoring,while a third assessed imaging features(maximum lesion diameter,solid component diameter,volume)and measured ADCmean.Clinical parameters(age,menopausal status,CA199,CA125,HE4)were collected.Univariate analysis compared benign and malignant groups.General characteristic model and integrated model(general characteristics+ADCmean)were established,with diagnostic performance compared.Malignancy risk assessment for O-RADS MRI category 4 lesions was adjusted based on the optimal model.Results:The two radiologists demonstrated good interobserver agreement in O-RADS MRI scoring(Kappa=0.762).Univariate analysis revealed significant differences in age,menopausal status,CA199,CA125,HE4 levels,lesion size(maximum lesion diameter,solid component diameter,volume),and ADCmean(P<0.05).The integrated model exhibited superior diagnostic performance(AUC=0.969)compared to the general characteristics model(AUC=0.955).After adjustment in the integrated model,15 O-RADS-MRI category 4 lesions were reclassified as category 5(10 malignant,5 borderline),resulting in a decreased malignancy rate for category 4 lesions from 81.8%to 42.9%(P<0.05).Conclusion:DWI can improve the diagnostic efficiency of the nature of adnexal lesions and integrating ADC into the O-RADS MRI score can reduce the risk of malignancy in 4-point lesions,thereby providing a reliable reference for the clinical application of O-RADS.关键词
卵巢肿瘤/磁共振成像Key words
Ovarian Neoplasms/Magnetic Resonance Imaging分类
医药卫生引用本文复制引用
马璐阳,沈文,赵玉娇,张程,张智景,张晓萌,周彦岐,冀晓东,黄黎香,程悦..DWI对卵巢-附件影像报告和数据系统(O-RADS)MRI评分的附加价值[J].中国临床医学影像杂志,2025,36(6):437-441,5.基金项目
国家自然科学基金面上项目(82271971) （82271971）
天津市重点医学学科(专科)建设项目(TJYXZDXK-041A). （专科）
