DWI结合ADC值鉴别睾丸病变的价值  

DWI combined with ADC in the diagnosis of testicular lesions

作　　者：黄梦娜[1] 高雪梅[1] 程敬亮[1] 屈昭慧 黄梦月 吕晓婷[1] 

机构地区：[1]郑州大学第一附属医院磁共振科,河南郑州450052

出　　处：《实用放射学杂志》2018年第1期59-62,共4页Journal of Practical Radiology

摘　　要：目的 探讨扩散加权成像（DWI）和表观扩散系数（ADC）值鉴别睾丸良恶性病变的价值.方法 回顾性分析本院经手术及病理证实的35例睾丸病变患者,其中良性病变18例,恶性病变17例.均行MRI平扫、DWI扫描,并测量正常部分和病变的实质部分的平均ADC值.采用 K ruskal-W allis检验分析三者平均ADC值的差异是否具有统计学意义,绘制受试者工作特征曲线（ROC曲线）,计算鉴别良恶性病变的最佳ADC阈值.结果 33例睾丸正常部分的DWI呈均匀高信号,平均ADC值为（1.137 ± 0.119）×10-3mm2/s,18例良性病变的扩散多不受限,平均ADC值为（1.104 ± 0.463）×10-3mm2/s,17例恶性病变DWI呈高信号,平均ADC值为（0.778 ± 0.198）×10-3mm2/s,恶性组与正常组、恶性组与良性组的平均 ADC值的差异有统计学意义（P〈0.05）,良性组与正常组的平均ADC值的差异无统计学意义.鉴别睾丸病变良恶性的ADC阈值为0.911×10-3mm2/s,敏感度82.4%,特异度82.4%.结论 DWI结合ADC值有助于鉴别睾丸病变的良恶性.Objective To identify the diagnostic value of ADC combined with DWI in benign lesions and malignant lesions of testis. Methods 35 patients with testicular lesions confirmed by operation and pathological examination in our hospital were analyzed retrospectively, including 18 benign lesions and 17 malignant lesions.The mean ADC values of normal tissue and parenchyma of testicular lesions were measured and statistically analyzed by K ruskal-W allis test,and receiver operating characteristic（ROC）curve was delineated. The optimum ADC value for differential diagnosis of malignant testicular lesions was analyzed and determined.Results In 33 cases of normal testicular tissue DWI showed homogeneous high signal,and mean ADC was（1.137 ± 0.119）×10-3mm2/s.18 cases of benign lesions mostly showed unrestricted diffusion,and mean ADC was（1.104 ± 0.463）×10-3mm2/s.In 17 cases of malignant lesions DWI showed high signal,and mean ADC was（0.778 ± 0.198）×10-3mm2/s.The comparison of ADC mean values between malignant testicular lesions and normal tissue as well as benign lesions of testis showed significant difference（P〈0.05）.The optimum ADC to distinguish malignant testicular lesions from benign testicular lesions was 0.911×10 -3mm2/s（82.4% sensitivity and 82.4% specificity）. Conclusion DWI combined with ADC value is beneficial to the preoperative diagnosis and differential diagnosis between malignant testicular lesions and benign lesions of testis.

关 键 词：睾丸肿瘤 扩散加权成像 表观扩散系数 

分 类 号：R737.21[医药卫生—肿瘤] R445.2[医药卫生—临床医学]