弥散加权技术(DWI)在诊断卵巢癌复发及种植转移的应用价值  

Application Value of Diffusion Weighted Imaging(DWI)in the Diagnosis of Recurrence and Implant Metastasis of Ovarian Cancer

作　　者：张子钦[1] 郭晓婷 梁权海[1] 陈钦龙 谭仲伦 ZHANG Zi-qin;GUO Xiao-ting;LIANG Quan-hai;CHEN Qin-long;TAN Zhong-lun(Department of Radiology,Xinhui District People's Hospital,Jiangmen 529000,Guangdong Province,China;Department of Imaging,School of Medical Technology,Guangdong Jiangmen Vocational College of Traditional Chinese Medicine,Jiangmen 529000,Guangdong Province,China)

机构地区：[1]江门市新会区人民医院放射科,广东江门529000 [2]广东江门中医药职业学院医学技术学院影像教研室,广东江门529000

出　　处：《罕少疾病杂志》2023年第2期58-59,62,共3页Journal of Rare and Uncommon Diseases

基　　金：江门市卫生健康局科研项目(21A096)。

摘　　要：目的分析DWI(弥散加权技术)在诊断卵巢癌复发及种植转移的应用价值。方法本次研究对象来源于本院2019年1月至2022年1月收治的64例卵巢癌手术患者,分别给予常规MRI(磁共振成像)诊断、DWI扫描,将手术病理诊断结果作为本次研究的“金标准”,对比常规MRI、DWI诊断准确率、特异度、灵敏度,Kappa检验常规MRI、DWI与“金标准”的一致性。对比复发、种植转移组与未复发、未种植转移组ADC值。结果手术病理诊断确诊40例复发、种植转移,常规MRI确诊20例复发、种植转移,DWI确诊37例复发、种植转移。DWI诊断准确率(92.50%)、特异度(62.50%)、灵敏度(55.00%)高于常规MRI(50.00%、16.67%、40.00%),P<0.05,常规MRI与“金标准”的一致性一般(Kappa值=0.513),DWI与“金标准”的一致性较好(Kappa值=0.707)。复发、种植转移组ADC值低于未复发、未种植转移组,P<0.05(差异均具有统计学意义)。DWI确诊37例复发、种植转移患者中,4例种植转移至系膜,占10.81%;8例种植转移至网膜,占21.62%;6例种植转移至左结肠旁沟,占16.22%;5例种植转移至右结肠旁沟,占13.51%;10例种植转移至道格拉斯窝,占27.03%;4例种植转移至膈下,占10.81%。结论DWI可提高对卵巢癌复发及种植转移诊断准确率、特异度、灵敏度,复发、种植转移患者ADC值会明显降低。Objective To analyze the application value of DWI(diffusion weighted imaging)in the diagnosis of recurrence and implant metastasis of ovarian cancer.Methods The subjects of this study were 64 patients with ovarian cancer treated in our hospital from January 2019 to January 2022.They were given conventional MRI(magnetic resonance imaging)diagnosis and DWI scanning respectively.The results of surgical pathological diagnosis were taken as the gold standard of this study.The diagnostic accuracy,specificity and sensitivity of conventional MRI and DWI were compared,and the consistency between conventional MRI,DWI and the gold standard was tested by kappa.The ADC values of recurrent and implanted metastasis groups were compared with those of non recurrent and non implanted metastasis groups.Results 40 cases of recurrence and implant metastasis were diagnosed by operation and pathology,20 cases of recurrence and implant metastasis were diagnosed by routine MRI,and 37 cases of recurrence and implant metastasis were diagnosed by DWI.The diagnostic accuracy(92.50%),specificity(62.50%)and sensitivity(55.00%)of DWI were higher than those of conventional MRI(50.00%,16.67%and 40.00%),P<0.05.The consistency between conventional MRI and gold standard was general(kappa value=0.513),and the consistency between DWI and gold standard was good(kappa value=0.707).The ADC value of recurrence and implant metastasis group was lower than that of non recurrence and non implant metastasis group(P<0.05).Among the 37 patients with recurrence and implant metastasis diagnosed by DWI,4 cases had implant metastasis to mesangium,accounting for 10.81%;8 cases were transferred to omentum,accounting for 21.62%;6 cases(16.22%)were transferred to the left paracolonic sulcus;5 cases were transferred to the right paracolonic sulcus,accounting for 13.51%;10 cases were transferred to Douglas nest,accounting for 27.03%;4 cases(10.81%)were transplanted to the subphrenic region.Conclusion DWI can improve the diagnostic accuracy,specificity and sensitivity of o

关 键 词：弥散加权技术 卵巢癌 复发 种植转移 

分 类 号：R737.31[医药卫生—肿瘤]