METHODS: A retrospective analysis was conducted of patients aged 2-21 years who underwent ovarian mass resection between 2009 and 2021 at 11 pediatric hospitals. Sociodemographic information, clinical and imaging findings, tumor markers, and operative and pathology details were collected. Diagnostic performance for detecting malignancy was assessed by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for MRI with other diagnostic modalities.
RESULTS: One thousand and fifty-three patients, with a median age of 14.6 years, underwent resection of an ovarian mass; 10% (110/1053) had malignant disease on pathology, and 13% (136/1053) underwent preoperative MRI. MRI sensitivity, specificity, PPV, and NPV were 60%, 94%, 60%, and 94%. Ultrasound sensitivity, specificity, PPV, and NPV were 31%, 99%, 73%, and 95%. Tumor marker sensitivity, specificity, PPV, and NPV were 90%, 46%, 22%, and 96%. MRI and ultrasound concordance was 88%, with sensitivity, specificity, PPV, and NPV of 33%, 99%, 75%, and 94%. MRI sensitivity in ultrasound-discordant cases was 100%. MRI and tumor marker concordance was 88% with sensitivity, specificity, PPV, and NPV of 100%, 86%, 64%, and 100%. MRI specificity in tumor marker-discordant cases was 100%.
CONCLUSIONS: Diagnostic modalities used to assess ovarian neoplasms in pediatric patients typically agree. In cases of disagreement, MRI is more sensitive for malignancy than ultrasound and more specific than tumor markers. Selective use of MRI with preoperative ultrasound and tumor markers may be beneficial when the risk of malignancy is uncertain.
UNASSIGNED: This retrospective review of 1053 patients aged 2-21 years who underwent ovarian mass resection between 2009 and 2021 at 11 pediatric hospitals found that ultrasound, tumor markers, and MRI tend to agree on benign vs malignant, but in cases of disagreement, MRI is more sensitive for malignancy than ultrasound.
方法:回顾性分析2009-2021年间在11家儿科医院接受卵巢肿块切除术的2至21岁患者。社会人口统计信息,临床和影像学检查结果,肿瘤标志物,收集手术和病理细节。通过计算灵敏度来评估检测恶性肿瘤的诊断性能,特异性,阳性预测值(PPV),和其他诊断方式的MRI阴性预测值(NPV)。
结果:1,053例患者接受了卵巢肿块切除术,中位年龄为14.6岁;10%(110/1053)的患者病理为恶性疾病,13%(136/1053)的患者接受了术前MRI检查。MRI敏感度,特异性,PPV,净现值为60%,94%,60%,94%。超声灵敏度,特异性,PPV,净现值为31%,99%,73%,95%。肿瘤标志物敏感性,特异性,PPV,净现值为90%,46%,22%,96%。MRI和超声的敏感度为88%,特异性,PPV,净现值为33%,99%,75%,94%。超声不一致病例的MRI敏感性为100%。MRI与肿瘤标志物的一致性为88%,灵敏度高,特异性,PPV,净现值为100%,86%,64%,100%。肿瘤标志物不一致病例的MRI特异性为100%。
结论:用于评估儿科患者卵巢肿瘤的诊断方法通常是一致的。在分歧的情况下,MRI对恶性肿瘤比超声更敏感,比肿瘤标志物更特异。当恶性肿瘤的风险不确定时,选择性使用MRI与术前超声和肿瘤标志物可能是有益的。
■这项对2009-2021年间在11家儿科医院接受卵巢肿块切除术的1053例2-21岁患者的回顾性研究发现,肿瘤标志物,和MRI倾向于在良性和恶性方面达成一致,但在分歧的情况下,MRI对恶性肿瘤比US更敏感。