Sonographic predictors of ovarian malignancy
Sonographic predictors of ovarian malignancy
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DOI：
10.1002/jcu.22014
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发表时间：
2013-06-01
影响因子：
0.9
通讯作者：
Benacerraf, Beryl
中科院分区：
文献类型：
--
作者：
Barroilhet, Lisa;Vitonis, Allison;Benacerraf, Beryl
目的：探讨卵巢恶性肿瘤的超声声像图特征。研究对象包括249名在2005年12月至2010年2月期间在布里格姆妇女医院接受盆腔肿块经阴道超声检查的妇女。受试者接受手术切除肿块，并获得病理诊断。由一名对诊断和临床信息不知情的超声医师回顾性审查图像。每个肿块有12个超声特征评分。数据集分为训练集（n = 149）和测试集（n = 100）。在训练集中，使用逐步逻辑回归来衡量每个变量和特征组合，以识别与恶性肿瘤相关的那些。使用逻辑回归分析的结果，我们创建了一个三级风险分层，应用于测试集中受试者的超声图像，以评估其区分良性病变与浸润性和边缘性癌症的能力。结果高危病变包括所有内部有血管的肿块。在我们的测试集中，12例浸润性癌中有9例（75%）存在此特征，6例交界性病变中有1例（16.7%）存在此特征，82例良性肿块中有9例（11%）存在此特征。中等风险水平包括具有厚壁或厚间隔且无内部血流的病变。这种特征的组合识别了另外一种浸润性癌症和6种中的5种（83.3%）交界性肿瘤。具有低风险特征的肿块有2/49（4.0%）的恶性肿瘤发生率。结论在没有高或中危声像图特征的情况下，恶性肿瘤的风险较低。(c)2013 Wiley Periodicals，Inc.临床超声杂志，41：269274，2013
Purpose To identify a combination of sonographic features that best predicts ovarian malignancy. Methods Subjects included 249 women who had a transvaginal sonogram for a pelvic mass at Brigham and Women's Hospital between December 2005 and February 2010. Subjects underwent surgery for removal of the mass and pathologic diagnosis was available. Images were reviewed retrospectively by one sonologist blinded to diagnosis and clinical information. Twelve sonographic features were scored for each mass. The dataset was divided into training (n = 149) and testing (n = 100) sets. Within the training set, a stepwise logistic regression was used to weigh each variable and combination of features to identify those associated with malignancies. Using the results from the logistic regression analyses, we created a three-level risk stratification that was applied to the sonograms of subjects in the testing set to assess its ability to distinguish benign lesions from invasive and borderline cancers. Results High risk lesions included all masses with internal vascularity. In our testing set, this feature was present in 9 out of 12 (75%) invasive cancers, 1 out of 6 (16.7%) borderline lesions, and 9 out of 82 (11%) benign masses. The intermediate risk level included lesions with a thick wall or thick septa without internal blood flow. This combination of features identified one additional invasive cancer and 5 out of 6 (83.3%) borderline tumors. Masses with low risk features had a 2/49 (4.0%) incidence of malignancy. Conclusions In the absence of high or intermediate risk sonographic features, the risk of malignancy is low. (c) 2013 Wiley Periodicals, Inc. J Clin Ultrasound, 41:269274, 2013