DWI结合动态增强对卵巢囊实性肿瘤良、恶性的鉴别诊断价值  

Differentiating Value of Diffusion Weighted Imaging Combined with Dynamic Enhancement in Ovarian Tumors with Cystic and Solid Components

作　　者：何业银 李绍东 卢晓冬[2] 杨明[2] 

机构地区：[1]徐州医科大学附属医院影像科,江苏徐州221002 [2]江苏省泗阳县人民医院磁共振室,江苏泗阳223700

出　　处：《中国CT和MRI杂志》2017年第4期103-105,110,共4页Chinese Journal of CT and MRI

基　　金：江苏省自然基金资助(BK2007011)

摘　　要：目的探讨DWI技术结合动态增强扫描对卵巢囊实性肿瘤良、恶性的鉴别诊断价值。方法回顾性分析经手术病理证实的39例囊腺瘤(良性组)与36例囊腺癌(恶性组)患者的MR常规平扫、DWI及动态增强图像,测量良、恶性组实性成分的平均ADC值,并进行统计学分析。结果良性组实性成分平均ADC值为(1.62±0.24)×10^(-3)mm^2/s,恶性组实性成分平均ADC值为(0.92±0.15)×10^(-3)mm^2/s,良性组与恶性组实性成分ADC值之间差异有统计学意义(t=-14.999,p<0.001),DWI结合MR平扫+增强扫描对卵巢囊实性肿瘤良、恶性鉴别的正确指数、灵敏度、特异度、阳性预测值、阴性预测值分别为0.842、94.44%、89.74%、89.47%、94.59%,当选取阈值ADC值为1.26×10^(-3)mm^2/s,其诊断敏感性和特异性分别为92.3%、88.9%。结论 DWI结合动态增强扫描在卵巢囊实性肿瘤良、恶性的鉴别诊断中有很高的临床应用价值,应常规用于卵巢囊实性病变的术前检查。Objective This study aimed to investigate the role of DWI combined with dynamic enhancement in differentiating ovarian minors with solid and cystic components. Methods The routine MR imaging ,DWI and the ADC values of solid components and dynamic enhancement pictures of 75 ovarian tumors confirmed by surgeW and pathologW were retrospectively analyzed. Of the 75 patients, there were 39 cystadenomas （benign group） and 36 cystadenocarcinomas （malignant group）. The mean ADC. value of solid component were calculated and analyzed statistically, Results The mean ADC values of benign group was （1.62 ± 0.24）×100^-3mm^2/s, in malignant group was （0.92 ± 0.15）×100^-3mm^2/s,There were found to be significantly different （t=-14.999, P〈0.001）.The accuracy was 0.842, sensitivity was 94.44%,specificity was 89.74%,positive predictive value of 89.47%, and negative predictive value of 94.59% when conventional MP- imaging combined with DWI. ROC analysis indicated that a cutoff ADC value of 1.26×100^-3mm^2/s was associated with 92.3% sensitivity and 88.9% specificity. Conclusion DWI Colnbined with dynamic enhancement has high clinical application value in differential diagnosis of benign and malignant ovarian tumors, so it should be used in the preoperative examination of ovarian cystic and solid lesions.

关 键 词：DWI 动态增强 卵巢肿瘤 

分 类 号：R737.31[医药卫生—肿瘤] R445.2[医药卫生—临床医学]