Pelvic Adhesion Ultrasound New Scoring System: A Promising Preoperative Assessment Tool for Laparoscopy.

Abstract

Objective: To develop a new ultrasound-based scoring system for pelvic adhesions and evaluate its predictive performance through intraoperative findings during laparoscopy.

Methods: This prospective study was conducted from April 2023 to June 2024, including 152 adult patients undergoing laparoscopic surgery at our hospital. Imaging and clinical data were collected, and preoperative assessment of pelvic adhesions was performed using a novel ultrasound scoring system. Pearson correlation analysis was used to assess its correlation with the revised American Fertility Society (rAFS) score. The predictive performance, accuracy, and clinical utility of the new scoring system were evaluated from multiple perspectives using receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis (DCA), and clinical impact curves.

Results: Pearson correlation analysis showed a strong correlation (correlation coefficient = 0.88, P < .001) between the new ultrasound scoring system and rAFS. The area under the ROC curve (AUC) for predicting mild, moderate, and severe pelvic adhesions using the new scoring system were 0.927, 0.952, and 0.937, indicating good predictive performance. Calibration curve analysis demonstrated high predictive accuracy for pelvic adhesions. DCA indicated strong clinical utility of the new scoring system, and the clinical impact curve showed its ability to accurately identify high-risk pelvic adhesion patients during laparoscopic surgery.

Conclusions: The newly established scoring system demonstrated good predictive performance, discrimination, and clinical utility, providing a valuable guiding tool for the prediction of the presence or absence of adhesions.