MRI及DCE-MRI在卵巢肿瘤及肿瘤样病变的诊断价值  

Diagnostic Value of MRI and DCE-MRI in Ovarian Tumors and Tumor Like Lesions

作　　者：鲁龙龙 王栋[1] 连鹏[1] 张晖 LU Longlong;WANG Dong;LIAN Peng;et al(Xi'an People's Hospital / Xi'an Fourth Hospital, Shaanxi Xi'an 710004, China)

机构地区：[1]陕西省西安市人民医院/陕西省西安市第四医院医学影像中心,陕西西安710004

出　　处：《河北医学》2021年第11期1821-1826,共6页Hebei Medicine

基　　金：国家自然科学基金资助项目,(编号:81400181)。

摘　　要：目的:探究MRI及动态对比增强磁共振成像(Dynamic contrast-enhanced MR imaging,DCE-MRI)在卵巢肿瘤及肿瘤样病变的诊断价值。方法:选取2014年12月至2021年4月在本院接受治疗的卵巢肿瘤患者81例,计为卵巢肿瘤组;另选取同时期肿瘤样病变患者132作为对照,计为肿瘤样病变组(经手术病理验证)。收集两组患者的MRI、DCE-MRI资料,进行回顾性研究。结果:常规MRI检查显示,卵巢肿瘤组患者的病灶形状不规则、囊壁>3.0mm、实质成分>3.0mm、存在大量盆腔积液的几率大于肿瘤样病变组(P<0.05),病灶最大直径为12.30±3.68cm,大于肿瘤样病变组的9.00±1.01cm(P<0.05);DCE-MRI检查结果显示,感兴趣区域(Region of interest,ROI)卵巢肿瘤组患者的容量转移常数(Volume transfer constant,Ktrans)、血管外细胞外间隙容积比(Extravascular extracellular volume fraction,Ve)、速率常数(Rate constant,Kep)均大于肿瘤样病变组(P<0.05);受试者工作特征曲线(The receiver operating characteristic curve,ROC)分析显示,MRI、DCE-MRI联合甄别卵巢肿瘤、肿瘤样病变的敏感度最高为93.83%(P<0.05),约登指数、曲线下面积(Area under curve,AUC)分别为0.757、0.878,95%CI为0.827~0.919。结论:MRI及DCE-MRI对卵巢肿瘤、肿瘤样病变均具有一定的诊断价值,而两种联合鉴别价值最高;卵巢肿瘤患者病灶形状多为不规则,囊壁更厚、实质成分更多,直径更大,盆腔积液较多,同时患者DCE-MRI指标Ktrans、Kep、Ve更大,临床中可联合常规MRI和功能MRI对卵巢的良恶性进行甄别,可显著提高精确度,使患者尽早得到救治。Objective:To explore the diagnostic value of magnetic resonance imaging(MRI)and dynamic contrast-enhanced MRI(DCE-MRI)in ovarian tumors and tumor-like lesions.Methods:81 patients with ovarian tumors(ovarian tumor group)and 132 patients with tumor-like lesions confirmed by surgical pathology(tumor-like lesion group)were enrolled in this study between December 2014-April 2021.The MRI and DCE-MRI data of the two groups of patients were collected and analyzed retrospectively.Results:Conventional MRI showed that the probabilities of irregular lesions,capsule wall>3.0mm,parenchyma>3.0mm,and massive pelvic effusion were greater in the ovarian tumor group than in the tumor-like lesion group(P<0.05).The largest diameter of the lesion in the ovarian tumor group was(12.30±3.68)cm,larger than(9.00±1.01)cm in the tumor-like lesion group(P<0.05).DCE-MRI showed that the volume transfer constant(Ktrans),extravascular extracellular volume fraction(Ve),and rate constant(Kep)of the region of interest(ROI)in the ovarian tumor group were greater than those in the tumor-like lesion group(P<0.05).The receiver operating characteristic(ROC)curve analysis showed that the sensitivity of MRI combined with DCE-MRI in differential diagnosis of ovarian tumors and tumor-like lesions was the highest,which was 93.83%(P<0.05).Youden index,area under the curve(AUC)and 95%CI were 0.757,0.878,and 0.827~0.919.Conclusion:Both MRI and DCE-MRI have certain value in the diagnosis of ovarian tumors and tumor-like lesions,and the combination of the two has the highest value.Patients with ovarian tumors have more irregular lesions with thicker capsule walls,more parenchyma and larger diameters,more pelvic effusion,and larger Ktrans,Kep and Ve in DCE-MRI.In clinical practice,conventional MRI and functional MRI can be combined to differentiate benign and malignant ovarian lesions,thereby improving the accuracy and enable patients to receive treatment as soon as possible.

关 键 词：卵巢肿瘤 肿瘤样病变 MRI 动态对比增强磁共振成像 

分 类 号：R73[医药卫生—肿瘤]