To assess the diagnostic performance of MRI to predict ovarian malignancy alone and compared with other diagnostic studies. 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. 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%. 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. 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.

中文翻译：

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磁共振成像对小儿卵巢肿瘤的诊断性能：多机构评价

评估 MRI 单独预测卵巢恶性肿瘤的诊断性能，并与其他诊断研究进行比较。对2009年至2021年间在11家儿科医院接受卵巢肿块切除术的2-21岁患者进行回顾性分析。收集了社会人口学信息、临床和影像学结果、肿瘤标志物以及手术和病理学详细信息。通过计算 MRI 与其他诊断方式的敏感性、特异性、阳性预测值 (PPV) 和阴性预测值 (NPV) 来评估检测恶性肿瘤的诊断性能。 153 名患者接受了卵巢肿块切除术，中位年龄为 14.6 岁； 10% (110/1053) 的病理学结果为恶性疾病，13% (136/1053) 接受了术前 MRI 检查。 MRI 敏感性、特异性、PPV 和 NPV 分别为 60%、94%、60% 和 94%。超声敏感性、特异性、PPV 和 NPV 分别为 31%、99%、73% 和 95%。肿瘤标志物敏感性、特异性、PPV 和 NPV 分别为 90%、46%、22% 和 96%。 MRI 和超声一致性为 88%，敏感性、特异性、PPV 和 NPV 分别为 33%、99%、75% 和 94%。超声不一致病例的 MRI 敏感性为 100%。 MRI 和肿瘤标志物的一致性为 88%，敏感性、特异性、PPV 和 NPV 分别为 100%、86%、64% 和 100%。肿瘤标志物不一致病例的 MRI 特异性为 100%。用于评估儿科患者卵巢肿瘤的诊断方式通常是一致的。如果存在分歧，MRI 对恶性肿瘤的敏感性比超声检查更敏感，并且比肿瘤标志物更具特异性。当恶性肿瘤风险不确定时，选择性使用 MRI 结合术前超声和肿瘤标志物可能是有益的。这项回顾性研究对 2009 年至 2021 年间在 11 家儿科医院接受卵巢肿块切除术的 1053 名 2-21 岁患者进行了回顾性分析，发现超声、肿瘤标志物和 MRI 在良性与恶性方面往往达成一致，但在出现分歧的情况下，MRI 更倾向于一致。对恶性肿瘤比超声敏感。