Contrast-enhanced ultrasonography for differential diagnosis of adnexal masses

Weihui Shentu; Yin Zhang; Jiaojiao Gu; Fa Wang; Wei Zhao; Chunmei Liu; Zimei Lin; Yao Wang; Chen Liu; Yunyu Chen; Qiyun Fan; Hongying Wang

doi:10.3389/fonc.2022.968759

Contrast-enhanced ultrasonography for differential diagnosis of adnexal masses

Front Oncol. 2022 Oct 20:12:968759. doi: 10.3389/fonc.2022.968759. eCollection 2022.

Authors

Weihui Shentu¹, Yin Zhang¹, Jiaojiao Gu¹, Fa Wang¹, Wei Zhao¹, Chunmei Liu², Zimei Lin², Yao Wang², Chen Liu¹, Yunyu Chen¹, Qiyun Fan¹, Hongying Wang¹

Affiliations

¹ Department of Medical Ultrasonics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
² Department of Medical Ultrasonics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.

Abstract

Background: Quantitative contrast-enhanced ultrasonography parameters are affected by various factors. We evaluated corrected quantitative contrast enhanced ultrasonography in differentiating benign adnexal tumors from malignant tumors.

Methods: Patients with adnexal masses who underwent conventional and contrast-enhanced ultrasonography were included. Contrast-enhanced ultrasonography parameters such as base intensity, arrival time, peak intensity, time to peak intensity, ascending slope, and descending slope were measured. Corrected (time to peak intensity - arrival time) _mass/(time to peak intensity - arrival time) _uterus and (peak intensity - base intensity) _mass/(peak intensity - base intensity) _uterus were calculated. Lesions were confirmed by pathologic examination of surgical specimens.

Results: This study included 31 patients with 35 adnexal lesions including 20 (57.10%) benign and 15 (42.90%) malignant lesions. The corrected contrast-enhanced ultrasonography quantitative parameters in lesions were statistically different between malignant and benign groups (P<0.05). The optimal cut-off value for (time to peak intensity - arrival time) _mass/(time to peak intensity - arrival time) _uterus, ascending slope, and (peak intensity - base intensity) _mass/(peak intensity - base intensity) _uterus, and descending slope for differentiating malignant adnexal masses from benign tumors were 1.05 (area under curve: 0.93, P<0.05), 1.11 (area under curve: 0.83, P<0.05), 0.82 (area under curve: 0.73, P<0.05), and -0.27 (area under curve: 0.66, P=0.16), with sensitivity and specificity of 93.33% and 85.00%, 86.67% and 75.00%, 86.67% and 60.00%, and 54.55% and 66.67%, respectively.

Conclusions: Corrected contrast-enhanced ultrasonography parameters provide practical differential diagnosis value of adnexal lesions with high reliability for sonologists.

Keywords: adnexal mass; benign; contrast-enhanced ultrasound; malignant; ovarian cancer.