الفهرس 
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Abstract
T
he aim of this work is to determine the efficacy of the classification of ovarian lesions on an ultrasound basis.
This was a prospective observational study conducted on 30 females with ovarian lesions at the Radiology Department of Ain Shams University Hospitals for 6 months.
In the current study, the main clinical presentations were pelvic pain in 27 women (90%), abdominal distention in 9 women (30%), and both in 7 patients (23.3%).
In the present work, the age of females with malignant lesions was higher than the age of females with benign lesions (49.82 ± 10.75 vs 34.26 ± 13.25 years). Most of the women with malignant lesions (63.6%) were postmenopause while most of those with benign lesions (84.2%) were premenopause. There were statistically significant differences between benign and malignant lesions as regards menopausal state and age (P= 0.15, and 0.002, respectively).
In the current study, the benign lesions (n=19) tend to be unilateral, unilocular, with relatively small max diameter, with no internal solid component, not associated with abdominal ascites or peritoneal thickness/nodules, and record a color score 1 on ultrasound. On the contrary, the malignant lesions (n=11) tend to be bilateral, multilocular, with a relatively large max diameter, with an internal solid component, associated with abdominal ascites and peritoneal thickness/nodules, and record a color score 4 on ultrasound.
According to histopathology, 15 out of 19 lesions (78.9%) were diagnosed as benign lesions, and all 11 malignant lesions were confirmed as malignant lesions. On follow-up, 4 lesions (21.1%) were diagnosed as benign lesions. The studied ovarian lesions in our study were diagnosed as the following: 5 lesions (19.2%) as serous adenocarcinoma, 5 lesions (19.2%) as mucinous adenocarcinoma, 3 lesions (11.5%) as cystic teratoma, 3 lesions (11.5%) as simple cysts, 4 lesions as mucinous cystadenoma (15.3%), one lesion (3.8%) as endometrial carcinoma, one lesion (3.8%) as ovarian torsion, one lesion (3.8%) as hemorrhagic cyst, one lesion (3.8%) as benign Brenner ovarian tumor, one lesion (3.8%) as endometrioma, and one lesion (3.8%) as a follicular cyst.
The benign lesions of O-RADS 1, O-RADS 2, O-RADS 3, O-RADS 4, and O-RADS 5 represented 5.3%, 63.2%, 15.8%, 10.5% and 5.3% respectively. The malignant lesions of O-RADS 5, O-RADS 4 represented 81.8%, and 18.2%, respectively. There was a highly statistically significant difference between benign and malignant lesions in terms of the O-RADS score (P<0.001).
In order to assess the diagnostic performance of the O-RADS score to discriminate malignant from benign lesions, a ROC curve analysis was performed. O-RADS score (AUC of 0.959) showed a sensitivity of 100%, a specificity of 84.21%, PPV of 78.6%, and NPV of 100%, with the optimal cutoff value for predicting malignancy was >O-RADS 3.