目的：分析评价GI-RADS分级联合血清CA-125鉴别附件区肿块良恶性的临床价值。方法：回顾性分析经病理证实的159个附件区肿块的超声表现，记录厚壁、分隔、腹水、乳头状凸起、实性成分、内部血流6个超声特征，并进行GI-RADS分级；分析患者血清CA-125数据，结合血清CA-125数据对GI-RADS分级进行校准。结果：6个超声征象中，内部血流诊断附件区恶性肿瘤的约登指数和准确度最高，分别为63.1%、85.5%，厚壁最低，分别为16.8%、72.3%；GI-RADS分级联合血清CA-125与GI-RADS分级相比，诊断附件区恶性肿瘤的约登指数升高（79.4%、76.4%），准确度降低（91.2%、93.1%）。结论：单个超声征象中，内部血流诊断附件区恶性肿瘤的效能最高，厚壁最低；GI-RADS分级、GI-RADS分级联合血清CA-125诊断附件区恶性肿瘤均具有较高的价值，诊断效能无明显差别。
Abstract
Objective: To analyze the value of gynecologic imaging reporting and data system(GI-RADS) ultrasonographic stratification combined with serum CA-125 in diagnosing adnexal masses. Methods: Ultrasound manifestations of 159 adnexal masses confirmed by pathology were retrospectively analyzed according to 6 ultrasonic features: wall thickness, separation, ascites, papillary bulge, solid component, and internal blood flow. Then the adnexal masses were graded with GI-RADS ultrasonographic stratification, using the serum CA-125 data to calibrate the GI-RADS ultrasonographic stratification. Results: Of the 6 ultrasound signs, the Youden index and accuracy of the internal blood flow were the highest, 63.1% and 85.5% respectively. Those of the wall thickness were the minimum, 16.8% and 72.3% respectively. Compared to GI-RADS ultrasonographic stratification, GI-RADS ultrasonographic stratification combined with serum CA-125 showed higher Youden index(79.4%, 76.4%) and lower accuracy(91.2%, 93.1%). Conclusions: Of the 6 ultrasound signs, diagnostic efficiency of internal blood flow is the highest and that of wall thickness is the lowest in diagnosing adnexal malignancies. Both GI-RADS ultrasonographic stratification and GI-RADS ultrasonographic stratification combined with serum CA-125 in diagnosis of adnexal malignancies have high diagnostic value and no significant difference in diagnostic efficiency.
关键词
生殖器肿瘤 /
女（雌）性 /
超声检查
Key words
Genital neoplasms, female /
Ultrasonography
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