DCE-MRI与DWI对不同性质囊实性卵巢肿瘤的诊断价值分析  

Diagnostic Value of DCE-MRI and DWI for Miscellaneous Cystic Ovarian Tumors

作　　者：石良瑜 陈萍[1] 江燕萍[2] SHI Liang-yu;CHEN Ping;JIANG Yan-ping(Department of Radiology,Huangmei People's Hospital,Huanggang 436500,Hubei Province,China)

机构地区：[1]湖北省黄冈市黄梅县人民医院放射科,湖北黄冈436500 [2]湖北省武汉市中心医院放射科,湖北武汉430000

出　　处：《中国CT和MRI杂志》2019年第6期119-121,共3页Chinese Journal of CT and MRI

基　　金：湖北省自然科学基金,项目编号:2016CFB425

摘　　要：目的分析磁共振动态增强成像(DCE-MRI)与弥散加权成像(DWI)对良性与恶性囊实性卵巢肿瘤的诊断价值。方法收集我院经手术病理证实为囊实性卵巢肿瘤的120例患者临床资料,所有患者术前均进行常规MRI扫描、DCE-MRI及DWI扫描,分析其影像学特征,比较良性与恶性囊实性卵巢肿瘤表观扩散系数(ADC)、容量转运参数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积比(Ve),并评估其诊断效能。结果120例患者中恶性病变67例(55.83%),良性病变53例(44.17%)。囊实性卵巢恶性肿瘤实性部分ADC值显著低于良性肿瘤(P<0.05),囊性部分ADC值与良性肿瘤无显著差异(P>0.05)。当ADC=1.20×10^-3mm^2/s时,诊断灵敏度和特异度分别为86.57%、81.13%。囊实性卵巢恶性肿瘤实性部分Ktrans、Kep及Ve值均显著小于良性肿瘤(P<0.05)。当Ktrans=0.09min-1时,诊断灵敏度和特异度分别为83.58%、83.02%。DCE-MRI+DWI对良性与恶性囊实性卵巢肿瘤的诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值依次为94.03%、94.34%、94.17%、95.45%、92.59%,均高于单独DCE-MRI检测和单独DWI检测。结论DCE-MRI+DWI对良性与恶性囊实性卵巢肿瘤的诊断效能较好,可作为囊实性卵巢肿瘤术前诊断重要方法。Objective To analyze the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) for benign and malignant cystic ovarian tumors.Methods The clinical data of 120 patients with cystic ovarian tumor confirmed by surgery and pathology in our hospital were collected.All patients were treated with routine MRI scan,DCE-MRI and DWI scan, the imaging features were analyzed,the apparent diffusion coefficient (ADC),volume transport parameter (Ktrans),rate constant (Kep),extravascular extracellular space volume ratio (Ve) in benign and malignant cystic ovarian tumors were compared,the diagnostic efficacy was evaluated.Results Among the 120 patients,there were 67 (55.83%) with malignant lesions and 53 (44.17%) with benign lesions.The ADC value of solid part of cystic ovarian malignant tumor was significantly lower than that of benign tumor (P<0.05).There was no significant difference between cystic part ADC and benign tumor (P>0.05).When ADC equaled to 1.20×10^-3mm^2/s,the diagnostic sensitivity and specificity were 86.57% and 81.13%,respectively.The Ktrans,Kep and Ve values of solid parts of cystic ovarian malignant tumors were significantly lower than those of benign tumors (P<0.05).When Ktrans equaled to 0.09min-1,the diagnostic sensitivity and specificity were 83.58% and 83.02%,respectively.The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value by DCE-MRI combined with DWI for benign and malignant cystic ovarian tumors were 94.03%,94.34%,94.17%,95.45%,and 92.59%, respectively,all higher than the values by DCE-MRI alone and DWI alone.Conclusion DCE-MRI combined with DWI has a good diagnostic effect on benign and malignant cystic ovarian tumors,it can be used as an important method for preoperative diagnosis of cystic ovarian tumors.

关 键 词：磁共振动态增强成像 弥散加权成像 囊实性卵巢肿瘤 

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