O-RADS美国版（卵巢附件报告与数据系统）首次发表于2019年，为卵巢和附件病变提供了一个标准化的词汇，并通过基于形态特征的数字评分对这些病变进行分层，以指示恶性风险，并提供管理指导。该风险分层系统随后在回顾性研究中得到验证，并且在不同专业水平的用户之间也取得了良好的读者之间一致性。随着该系统的使用增加，人们认识到需要进行更新，以解决特定的临床挑战，澄清建议，并整合验证研究中的新数据。O-RADS美国版新增了有利于良性的进一步形态特征，比如用于无实质成分的囊肿的双室特征以及用于具有光滑轮廓的实质性病变的阴影，以便进行最适宜的风险评分。由于已经证明O-RADS美国版4级在恶性肿瘤的切割点上是适当的，现在建议对低风险的O-RADS美国版3级病变，在未切除的情况下进行超声检查。现在强调进一步利用磁共振成像对实质性病变和具有实质成分的囊性病变进行进一步描述，因为磁共振成像可能提供更高的特异性。本文总结了O-RADS美国版2022年版本中所包含的治理概念、词汇术语和评估类别以及管理建议的更新情况。© RSNA, 2023.

First published in 2019, the Ovarian-Adnexal Reporting and Data System (O-RADS) US provides a standardized lexicon for ovarian and adnexal lesions, enables stratification of these lesions with use of a numeric score based on morphologic features to indicate the risk of malignancy, and offers management guidance. This risk stratification system has subsequently been validated in retrospective studies and has yielded good interreader concordance, even with users of different levels of expertise. As use of the system increased, it was recognized that an update was needed to address certain clinical challenges, clarify recommendations, and incorporate emerging data from validation studies. Additional morphologic features that favor benignity, such as the bilocular feature for cysts without solid components and shadowing for solid lesions with smooth contours, were added to O-RADS US for optimal risk-appropriate scoring. As O-RADS US 4 has been shown to be an appropriate cutoff for malignancy, it is now recommended that lower-risk O-RADS US 3 lesions be followed with US if not excised. For solid lesions and cystic lesions with solid components, further characterization with MRI is now emphasized as a supplemental evaluation method, as MRI may provide higher specificity. This statement summarizes the updates to the governing concepts, lexicon terminology and assessment categories, and management recommendations found in the 2022 version of O-RADS US.© RSNA, 2023.