摘要

目的:比较恶性风险指数4(risk of malignancy index 4,RMI4)、超声国际卵巢肿瘤研究组(International Ovarian of Tumor Analysis, IOTA)简易标准及妇科影像报告与数据系统(gynecologic imaging reporting and data system, GI-RADS)鉴别诊断卵巢良恶性肿瘤的价值。方法:回顾分析对比经术后病理或最终临床随访证实的299例卵巢肿瘤患者的超声图像特征,分别用RMI4、IOTA简易标准和GI-RADS预测其肿块的良恶性,比较3种方法鉴别诊断卵巢肿瘤的效能。结果:299例卵巢肿块中,良性肿瘤191例,恶性肿瘤108例。IOTA简易标准的敏感度与准确度均高于GI-RADS,差异有统计学意义(χ~2=5.860,P=0.015;χ~2=7.650,P=0.006),特异度、阳性预测值及阴性预测值的差异则无统计学意义(χ~2=2.276,P=0.131;χ~2=2.599,P=0.107;χ~2=5.465,P=0.019);IOTA简易标准的敏感度、阳性预测值、阴性预测值及准确度均高于RMI4,差异有统计学意义(χ~2=20.415,P<0.017;χ~2=6.841,P<0.017;χ~2=16.897,P<0.017;χ~2=22.643,P<0.017),特异度的差异则无统计学意义(χ~2=4.702,P=0.030);GI-RADS的敏感度高于RMI4,差异有统计学意义(χ~2=5.939,P=0.015),特异度、阳性预测值、阴性预测值及准确度的差异均无统计学意义(χ~2=0.517,P=0.472;χ~2=1.220,P=0.269;χ~2=4.336,P=0.037;χ~2=5.050,P=0.025)。结论:IOTA简易标准、GI-RADS与RMI4对鉴别卵巢良恶性肿块均有重要临床价值,其中IOTA简易标准诊断效能最优。