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      Clinical significance of transvaginal color Doppler ultrasound for the differential diagnosis of benign and malignant ovarian cysts

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          Abstract

          Objective To evaluate the clinical significance of transvaginal color Doppler ultrasound for the differential diagnosis of benign and malignant ovarian cysts.

          Methods Patients who were diagnosed with clinically suspected or palpable adnexal masses and underwent gray-scale ultrasonography, transvaginal color Doppler ultrasonography, and ultrasoundguided fine-needle aspiration cytology (FNAC) during the period from 2018 to 2021 were enrolled in this study. The pulsatility index ( PI) and resistance index ( RI) were estimated, and an ovarian cyst with the lowest PI value of < 1.0 or the lowest RI 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.

          Results 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 ( χ 2 = 49.29, P < 0.01). Among the 75 patients with blood-flow signals in malignant ovarian cysts, 75 had PI < 1.0 and 24 had RI < 0.4; among the 42 patients with blood-flow signals in benign ovarian cysts, 15 had PI < 1.0 and no one had RI < 0.4; there were significant differences in the proportions of PI < 1.0 and RI < 0.4 between the two groups ( χ 2 = 62.68, P < 0.01; χ 2 = 16.91, P < 0.01). In addition, compared with the combination of grayscale ultrasound and transvaginal color Doppler ultrasound, gray-scale ultrasound alone had significantly lower sensitivity (51.85% vs 81.48%; χ 2 = 16.00, P < 0.01), specificity (75.76% vs 93.94%; χ 2 = 12.73, P < 0.01), PPV (63.64% vs 91.67%; χ 2 = 15.90, P < 0.01), and NPV (65.79% vs 86.11%; χ 2 = 12.44, P < 0.01) for the differential diagnosis of benign and malignant ovarian cysts.

          Conclusion 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.

          Abstract

          摘要: 目的 评价经阴道彩色多普勒超声用于诊断卵巢囊肿良恶性的价值。 方法 以 2018—2021 年接受诊疗的临 床疑似或可触及的子宫附件肿块患者, 且接受灰阶超声图像、经阴道彩色多普勒超声及超声引导下细针穿刺细胞学检 查(FNAC)为研究对象。计算搏动指数( PI)和阻力指数( RI), 以 PI 最低值 < 1.0 或 RI 最低值 < 0.4 定义该卵巢囊肿为 恶性。以 FNAC 检测结果为金标准, 评价灰阶超声图像和经阴道彩色多普勒超声用于鉴别卵巢囊肿良恶性的敏感性、 特异性、阳性预测值(PPV)和阴性预测值(NPV)。 结果 180 例卵巢囊肿患者中, 经 FNAC 确诊卵巢恶性病变 81 例、 卵巢良性病变 99 例。经阴道彩色多普勒超声图像上, 75 例卵巢恶性病变患者卵巢囊肿出现血流信号(92.59%)、42 例 卵巢良性病变患者卵巢囊肿出现血流信号(42.24%), 差异有统计学意义( χ 2 = 49.29, P < 0.01)。囊肿内出现血流信号 的 75 例卵巢恶性病变患者中, 75 例患者 PI 值均 < 1.0, 24 例患者 RI 值< 0.4;囊肿内出现血流信号的 42 例卵巢良性 病变患者中, 15 例患者 PI 值 < 1.0, 未见 RI 值 < 0.4 的患者;囊肿内出现血流信号的卵巢良、恶性病变患者 PI 值 < 1.0 和 RI 值 < 0.4 比例差异均有统计学意义( χ 2 = 62.68, P < 0.01; χ 2 = 16.91, P < 0.01)。灰阶超声图像用于鉴别卵巢囊 肿良恶性的敏感度、特异度、PPV 和 NPV 分别为 51.85%、75.76%、63.64% 和 65.79%, 灰阶超声图像 + 彩色多普勒超 声用于鉴别卵巢囊肿良恶性的敏感度、特异度、PPV 和 NPV 分别为 81.48%、93.94%、91.67% 和 86.11%, 差异具有统 计学意义( χ 2 = 16.00、12.73、15.90、12.44, P 均 < 0.01)。 结论 灰阶超声图像具有诊断卵巢囊肿的价值, 联合应用经 阴道彩色多普勒超声和灰阶超声图像可提高卵巢囊肿良恶性诊断能力。

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          Author and article information

          Journal
          CJRH
          Chinese Journal of Radiological Health
          Chinese Preventive Medical Association (Ji’an, China )
          1004-714X
          01 December 2022
          01 March 2023
          : 31
          : 6
          : 731-734
          Affiliations
          [1] 1Department of Ultrasound, Changzhou Municipal Maternal and Child Healthcare Hospital, Changzhou 213004 China
          Article
          j.issn.1004-714X.2022.06.016
          10.13491/j.issn.1004-714X.2022.06.016
          90c30267-d75c-4267-a053-0eae2e61db52
          © 2022 Chinese Journal of Radiological Health

          This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

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          Categories
          Journal Article

          Medicine,Image processing,Radiology & Imaging,Bioinformatics & Computational biology,Health & Social care,Public health
          Gray-scale ultrasound,Diagnostic value,Ovarian cyst,Transvaginal color Doppler ultrasound

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