磁共振多参数定量分析在区分卵巢-附件O-RADS MRI4分病变良恶性的价值  

Value of Quantitative Analysis of Multiparameter MRI in Differentiation of Benign and Malignant Ovarian Lesions with O-RADS MRI Score 4

作　　者：雷岩[1] 宋彬[1] 刘恋恋 张远[1] 郑婷婷 沈钧康[2] LEI Yan;SONG Bin;LIU Lianlian;ZHANG Yuan;ZHENG Tingting;SHEN Junkang(Department of Radiology,Minhang District Central Hospital,Fudan University;Department of Radiology,The Second Affiliated Hospital,SoochowUniversity)

机构地区：[1]复旦大学附属闵行医院放射科 [2]苏州大学附属第二人民医院放射科

出　　处：《中国医学计算机成像杂志》2023年第1期50-57,共8页Chinese Computed Medical Imaging

基　　金：上海市闵行区科学技术委员会自然科学基金项目(2019MHZ050)。

摘　　要：目的:评价磁共振多参数定量分析对区分卵巢-附件磁共振成像报告和数据系统(O-RADSMRI)4分病变良性和恶性的价值.方法:回顾性分析41例(44个)O-RADSMRI评分为4分的病灶,测量表观弥散系数(ADC)值、T2WI信号强度比值、T1WI增强强化率及信号强度值相应标准差.根据单因素分析结果确定最佳定量参数,采用受试者工作特征(ROC)曲线分析及约登指数确定最优参数阈值并组合为不同诊断模型,计算相应诊断效能.结果:入组44个病灶中26个(59.1%)为恶性.恶性组T2WI信号强度值标准差[11.2(5.1,23.25)vs 58.95(32.3,78.58),P=0.001]、最低信号区ADC平均值[1.16(1.0,1.5)×10^(-3)mm^(2)/s vs 1.79(1.31,2.21)×10^(-3)mm^(2)/s,P=0.001]及最小值[(1.11±0.38)×10-5 mm^(2)/s vs(1.63±0.51)×10^(-3)mm^(2)/s,P<0.001]明显低于良性组.T2WI信号强度值标准差<40.85联合最低信号区ADC最小值<1.38x 10^(-3)mm^(2)/s,预测O-RADS MRI评分4分病变良、恶性的特异度为88.9%,阳性预测值为89.5%;而T2WI信号强度值标准差>40.85联合最低信号区ADC最小值>1.38×10^(-3) mm^(2)/s,预测O-RADS MRI评分4分病变良、恶性的灵敏度及阴性预测值均为100.0%.结论:磁共振多参数定量分析可用于区分O-RADSMRI评分4分病变的良、恶性,对临床决策提供一定的帮助.Purpose:To evaluate the value of quantitative analysis of multiparameter MRI in differentiating the malignant from benign ovarian lesions with ovarian-adnexal reporting and data system MRI(O-RADS MRI)score 4.Methods:The data from 44 lesions(41 patients)with O-RADS-MRI score 4 were analyzed retrospectively.Apparent diffusion coefficient(ADC)value,T2WI signal intensity ratio,T1 WI enhancement ratio,and corresponding standard deviation of signal intensity value of each lesion were measured.The optimal quantitative parameters were determined according to the result of univariate analysis,and Youden index were used to determine the optimal cutoff values.The diagnostic performance of different combinations of the optimal quantitative parameters was evaluated by receiver operating characteristic(ROC)curve analysis.Results:Among 44 included lesions,26(59.1%)were malignant.Malignant group demonstrated significantly lower standard deviation of signal intensity on T2WI(T2WIsD)[11.2(5.1,23.25)vs 58.95(32.3,78.58),P=0.001]and minimum ADC value(ADCmin),average ADC value[(1.11±0.38)×10^(-3)mm^(2)/s vs(1.63±0.51)×10mm^(2)/s,P<0.001;1.16(1.0,1.5)×10-mm^(2)/s vs 1.79(1.31,2.21)×10^(-3)mm^(2)/s,P=0.001]in the lowest signal intensity area than benign group.With T2WIsp<40.85 and ADCmn<1.38×10^(-3)mm'/s,the specificity and positive predictive value of differentiation of benign and malignant lesions with O-RADSMRIscore 4 were 88.9%and 89.5%,respectively.With T2WIsp>40.85 and ADCmi>1.38×10°mm^(2)/s,the sensitivityand negative predictive value were 100.0%for both.Conclusions:The quantitative analysis of multiparameter MRIcan be used to differentiate the malignant from benign ovarian lesions with O-RADS-MRI score 4,which maysupport clinical decision-making.

关 键 词：磁共振成像 卵巢病变 卵巢-附件报告和数据系统 良恶性病变 

分 类 号：R445.2[医药卫生—影像医学与核医学]