卵巢-附件回报和数据系统（O-RADS）是一种词汇和风险分层系统，包括所有风险类别和相关管理建议。它在诊断恶性附件肿瘤方面具有较高的敏感性，但特异性较低。为了探索O-RADS结合增强超声（CEUS）在卵巢附件肿块风险分层中的价值，对85例患者的100个术前接受常规超声和CEUS检查并获得术后病理结果的附件肿块进行了回顾性研究。肿块根据常规超声被分为O-RADS2、3、4和5级。在增强超声后，根据CEUS成像特征对O-RADS进行了调整。具有不规则血管或内部不均匀高增强等可疑恶性特征的O-RADS2和3病变升级为O-RADS4，具有上述特征的O-RADS4病变升级为O-RADS5。具有规则血管、内部低增强或非增强等可疑良性血管特征的O-RADS4病变降级为O-RADS3；具有环形边缘增强和内部非增强等特征的O-RADS5病变降级为O-RADS3。将病理结果作为金标准，比较了两种方法的敏感性、特异性、准确性、阳性预测值、阴性预测值和曲线下面积（AUC）。O-RADS和O-RADS结合CEUS在恶性卵巢附件肿瘤诊断中的敏感性、特异性、准确性、阳性预测值、阴性预测值和AUC分别为96.6%、66.2%、75.0%、53.8%、97.9%、0.910和96.6%、91.5%、93.0%、82.4%、98.5%、0.962。O-RADS结合CEUS的特异性、准确性、阳性预测值和AUC均明显高于O-RADS（P < 0.01）。此外，两种方法的敏感性和阴性预测值均很好，但它们之间没有显著差异（P > 0.05）。O-RADS和CEUS的联合应用可以显著提高恶性卵巢附件肿瘤的特异性和阳性预测值。在卵巢附件肿块的风险分层临床应用中具有良好的前景。© 2023. BioMed Central Ltd., part of Springer Nature.

Ovarian-Adnexal Reporting and Data System (O-RADS) for ultrasound is a lexicon and risk stratification system that includes all risk categories and relevant management recommendation. It has high sensitivity in diagnosing malignant adnexal tumors, but the specificity is lower.To explore the value of O-RADS combined with contrast-enhanced ultrasound (CEUS) in risk stratification of adnexal masses.A retrospective study was performed on 85 patients with 100 adnexal masses that preoperatively underwent conventional ultrasound as well as CEUS examination and obtained the postoperative pathological results. The masses were classified into O-RADS2, 3, 4, and 5 by conventional ultrasound. After contrast enhancement, the classification of O-RADS was adjusted according to CEUS imaging features. The O-RADS 2 and 3 lesions with suspected malignant features like irregular blood vessels or internal inhomogeneous hyperenhancement were upgraded to O-RADS 4, and the O-RADS 4 lesions with the above features were upgraded to O-RADS 5. The O-RADS 4 lesions with suspicious benign angiographic features like a regular vessel, interior hypoenhancement or non-enhancement were downgraded to O-RADS 3; the O-RADS 5 lesions with rim ring-enhancement and interior non-enhancement were downgraded to O-RADS 3. The sensitivity, specificity, accuracy, PPV, NPV, and AUC of the two methods were compared, taking pathological results as the gold standard.The sensitivity, specificity, accuracy, PPV, NPV, and AUC of O-RADS and O-RADS combined with CEUS in the diagnosis of malignant adnexal tumors were 96.6%, 66.2%, 75.0%, 53.8%, 97.9%, 0.910 and 96.6%, 91.5%, 93.0%, 82.4%, 98.5%, 0.962, respectively. The specificity, accuracy, PPV, and AUC of O-RADS combined with CEUS were considerably higher than those of O-RADS (P < 0.01). Furthermore, both methods had excellent sensitivity and NPV but there were no significant differences between them(P > 0.05).Combination of O-RADS and CEUS can significantly improve the specificity and PPV in diagnosing malignant adnexal tumors. It seems promising in the clinical application of risk stratification of adnexal masses.© 2023. BioMed Central Ltd., part of Springer Nature.