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Дифференциальная ультразвуковая диагностика доброкачественных и злокачественных опухолей яичников: диагностические модели, алгоритмы, стратификационные системы, консенсусы (1990–2023)

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В обзоре представлены наиболее распространенные диагностические модели, алгоритмы и стратификационные системы, разработанные с целью оптимальной дифференциальной диагностики доброкачественных и злокачественных новообразований яичников с 1990 г. по настоящее время. Описаны 4 варианта индекса риска малигнизации RMI 1–4 с их сравнительными характеристиками. Описана собственная комплексная ультразвуковая шкала балльной оценки опухолей яичников. Представлены алгоритмы комплексного использования эхографии и онкомаркеров (СА-125, HE4, ROMA), в том числе компьютерная система Risk Ovarian Cancer. Описаны все существующие на сегодня диаг ностические модели IOTA: Простые правила IOTA, Простые правила IOTA с количественным расчетом риска малигнизации, Логистический регресси онный анализ IOTA LR1 & LR2, Простые дескрипторы IOTA, IOTA ADNEX. Представлены основные алгоритмы комплексного использования моделей IOTA. Изложены принципы использования диаг ностических стратификационных систем GI-RADS и O-RADS. Приведены клинические примеры использования диагностических моделей. Обзор завершается представлением консенсуса ESGO/ISUOG/ IOTA/ESGE по предоперационной диагностике опухолей яичников.

Ключевые слова:
ультразвуковая диагностика, опухоли яичников, СА-125, RMI, HE4, ROMA, IOTA LR1 & LR2, IOTA ADNEX, GI-RADS, O-RADS

Литература:
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Differential ultrasound diagnosis of benign and malignant ovarian tumors: diagnostic models, algorithms, stratification systems, consensuses (1990–2023).

The review presents the most common diagnostic models, algorithms and stratification systems developed for the purpose of optimal differential diagnosis of benign and malignant ovarian tumors from 1990 to the present. Four variants of the RMI 1–4 malignancy risk index with their comparative characteristics are described. A proprietary comprehensive ultrasound scoring scale for ovarian tumors is described. Algorithms for the integrated use of echography and tumor markers (CA-125, HE4, ROMA), including the Risk Ovarian Cancer computer system, are presented. All existing IOTA diagnostic models are described: Simple IOTA rules, Simple IOTA rules with quantitative calculation of the risk of malignancy, Logistic regression analysis IOTA LR1 & LR2, Easy IOTA descriptors, IOTA ADNEX. The main algorithms for the integrated use of IOTA models are presented. The principles of using the diagnostic stratification systems GI-RADS and O-RADS are outlined. Clinical examples of the use of diagnostic models are given. The review concludes by presenting the ESGO/ISUOG/IOTA/ESGE consensus on the preoperative diagnosis of ovarian tumors.

Keywords:
ультразвуковая диагностика, опухоли яичников, СА-125, RMI, HE4, ROMA, IOTA LR1 & LR2, IOTA ADNEX, GI-RADS, O-RADS