背景 卵巢附件成像报告和数据系统 (O-RADS) US 风险评分可用于根据形态特征准确对卵巢病变进行分层。然而，尚无大型多中心研究评估使用 O-RADS US 2022 版风险评分对因卵巢或附件病变转诊接受手术的患者的潜在影响。目的 回顾性确定无急性症状的卵巢或附件病变患者可能已使用 O-RADS US 2022 版风险评分进行保守治疗的比例。材料和方法 这项多中心回顾性研究纳入了 2011 年 1 月至 2014 年 12 月期间在引入 O-RADS US 之前在 US 后接受手术切除的卵巢囊性病变和非急性症状的患者。研究人员对最终诊断不知情，记录了病变成像特征和 O- RADS 美国风险评分。计算恶性肿瘤的发生率和风险评分的诊断性能。进行Mann-Whitney检验和Fisher精确检验，P < .05表明差异有统计学意义。结果共纳入377例手术切除病灶的患者。在切除的病灶中，42%（377 例中的 157 例）的 O-RADS US 风险评分为 2。在 O-RADS US 2 级病灶中，54%（157 例中的 86 例）为非肿瘤性，45%（157 例中的 70 例）是皮样瘤或其他良性肿瘤，不到 1%（157 例之一）是恶性的。使用 O-RADS US 4 作为恶性肿瘤预测的最佳阈值，获得了 94%（72 人中的 68 人）的敏感性、64%（305 人中的 195 人）的特异性、38%（178 人中的 68 人）的阳性预测值和 98%（178 人中的 195 人）的预测值。 199) 阴性预测值。结论 在 O-RADS US 风险评分发布之前接受卵巢和附件病变手术的无急性症状的患者中，近一半 (42%) 的手术切除病变回顾性符合 O-RADS US 2 版 2022 标准。对于这些患者，可以提供影像学随访或保守治疗。 © RSNA，2024 本文提供补充材料。另请参阅本期 Fournier 的社论。

Background The Ovarian-Adnexal Imaging Reporting and Data System (O-RADS) US risk score can be used to accurately stratify ovarian lesions based on morphologic characteristics. However, there are no large multicenter studies assessing the potential impact of using O-RADS US version 2022 risk score in patients referred for surgery for an ovarian or adnexal lesion. Purpose To retrospectively determine the proportion of patients with ovarian or adnexal lesions without acute symptoms who may have been managed conservatively by using the O-RADS US version 2022 risk score. Materials and Methods This multicenter retrospective study included patients with ovarian cystic lesions and nonacute symptoms who underwent surgical resection after US before the introduction of O-RADS US between January 2011 and December 2014. Investigators blinded to the final diagnoses recorded lesion imaging features and O-RADS US risk scores. The frequency of malignancy and the diagnostic performance of the risk score were calculated. The Mann-Whitney test and Fisher exact test were performed, with P < .05 indicating a statistically significant difference. Results A total of 377 patients with surgically resected lesions were included. Among the resected lesions, 42% (157 of 377) were assigned an O-RADS US risk score of 2. Of the O-RADS US 2 lesions, 54% (86 of 157) were nonneoplastic, 45% (70 of 157) were dermoids or other benign tumors, and less than 1% (one of 157) were malignant. Using O-RADS US 4 as the optimal threshold for malignancy prediction yielded a 94% (68 of 72) sensitivity, 64% (195 of 305) specificity, 38% (68 of 178) positive predictive value, and 98% (195 of 199) negative predictive value. Conclusion In patients without acute symptoms who underwent surgery for ovarian and adnexal lesions before the O-RADS US risk score was published, nearly half (42%) of surgically resected lesions retrospectively met the O-RADS US 2 version 2022 criteria. In these patients, imaging follow-up or conservative management could have been offered. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Fournier in this issue.