Comparison of performance between O-RADS, IOTA simple rules risk assessment and ADNEX model in the discrimination of ovarian Brenner tumors.

PURPOSE: To describe the clinical and sonographic features of ovarian benign Brenner tumor (BBT) and malignant Brenner tumor (MBT), and to compare performance of four diagnostic models in differentiating them. METHODS: Fifteen patients with BBTs and nine patients with MBTs were retrospectively identified in our institution from January 2003 and December 2021. One ultrasound examiner categorized each mass according to ovarian-adnexal reporting and data system (O-RADS), international ovarian tumor analysis (IOTA) Simple Rules Risk (SR-Risk) assessment and assessment of different neoplasias in the adnexa (ADNEX) models with/without CA125. Receiver operating characteristic curves were generated to compare diagnostic performance. RESULTS: Patients with MBT had higher CA125 serum level (62.5% vs. 6.7%, P = 0.009) and larger maximum diameter of lesion (89 mm vs. 43 mm, P = 0.009) than did those with BBT. BBT tended to have higher prevalence of calcifications (100% vs. 55.6%, P = 0.012) and acoustic shadowing (93.3% vs. 33.3%, P = 0.004), and lower color scores manifesting none or minimal flow (100.0% vs. 22.2%, P < 0.001). Areas under curves of O-RADS, IOTA SR-Risk and ADNEX models with/without CA125 were 0.896, 0.913, 0.892 and 0.896, respectively. There were no significant differences between them. CONCLUSION: BBTs are often small solid tumors with sparse color Doppler signals, which contain calcifications with posterior acoustic shadowing. The most common pattern of MBT is a large multilocular-solid or solid mass with irregular tumor borders, and most were moderately or richly vascularized at color Doppler. These four models have excellent performance in distinguishing them.

The ratio of cavum septi pellucidi width to anteroposterior cerebellar diameter: A novel index as a diagnostic adjunct for prenatal diagnosis of trisomy 18.

AIM: To explore the effectiveness of cavum septi pellucidi (CSP) width to anteroposterior cerebellar diameter (APCD) ratio as a diagnostic adjunct for prenatal diagnosis of trisomy 18. METHODS: Images of normal fetal brain within 15 and 35 weeks were stored in our center from 2016 to 2017. Images of aneuploid fetuses were retrospectively collected from 2004 to 2017. The transverse cerebellar diameter, APCD and CSP width were measured. CSP/APCD and APCD/transverse cerebellar diameter ratios were calculated and compared between euploid and aneuploid fetuses. RESULTS: One thousand and forty one fetuses were analyzed, including 817 euploid fetuses and 224 aneuploid fetuses (trisomy 21 117 cases, trisomy 18 82 cases, trisomy 13 9 cases, sex-linked 16 cases). No correlation had been found between both ratios and gestational weeks (P > 0.05). In aneuploid groups, means of ratios were both significantly different just between trisomy 18 group and euploid group (P < 0.05). The best area under the curve was shown by the CSP/APCD ratio. The cutoff value of CSP/APCD was 0.46 (sensitivity 87.0%, specificity 85.0%). CONCLUSION: A wide CSP or cerebellar hypoplasia warrants a more detailed ultrasound screening and genetic counseling. A larger CSP/APCD ratio alerts us to trisomy 18 syndrome, especially in cases with subtle anomalies.

[Ultrasonographic fetal nasal bone assessment in prenatal screening for Down syndrome].

OBJECTIVE: To investigate the clinic value of ultrasonographic fetal nasal bone examination as a screening marker for Down syndrome (DS). METHODS: The study was conducted in the First Affiliated Hospital of Sun Yat-sen University from Oct 2004 to Mar 2007. Two-dimensional ultrasound was used to assess the fetal nasal bone of 1863 normal pregnancies (normal group) and 25 cases with DS fetus (study group) during their second and third trimesters. The incidence of nasal bone absence or short nasal bone in two groups was determined. The fetal nasal bone absence should be confirmed in three orthogonal planes of the fetal face, and the short nasal bone included the cases that the fetal nasal bone was shorter than the 2.5th percentile of normal according to the gestational week. The diagnostic test index was used for assessing the value of fetal nasal bone abnormality as a marker in prenatal screening for DS. RESULTS: (1) 1761 fetuses of normal group were successfully examined for the nasal bone and the detection rate was 94.5% (1761/1863). 102 fetuses failed examination because of inconvenient intra-uterine position. (2) The nasal bone length grew in a linear fashion throughout pregnancy and the growth pattern correlated well with gestational age (r = 0.605, P < 0.05) in normal group. The nasal bone was absent in 3 normal fetuses (0.2%, 3/1761) and short nasal bone was found in 44 normal fetuses (2.5%, 44/1761). (3) The nasal bone was absent in 7 DS fetuses (28.0%, 7/25) and short nasal bone was found in 15 DS fetuses (60.0%, 15/25). (4) When the absence of nasal bone was used as a cut-off, the sensitivity for DS was 28.0%, the specificity was 99.8%, the positive likelihood ratio was 164.45 (95% CI: 45.11-599.60), and the negative likelihood ratio was 0.72 (95% CI: 0.57-0.92). When short nasal bone was used as a cut-off, the sensitivity was 60.0%, specificity was 97.5%, the positive likelihood ratio was 24.03 (95% CI: 7.15-80.71), and the negative likelihood ratio was 0.41 (95% CI: 0.29-0.59). CONCLUSION: Fetal nasal bone hypoplasia at the second and third trimester scan is associated with a high risk for Down syndrome and it can be used as a screen marker for this chromosomal abnormality.