ADC图纹理分析对卵巢上皮肿瘤的鉴别诊断价值  

The value of ADC texture analysis in differential diagnosis of ovarian epithelial tumors

作　　者：孙碧霞 朱大林[1] 张旭霞 钱吉芳[1] 李芸芝[1] 张彦辉 徐生芳 SUN Bixia;ZHU Dalin;ZHANG Xuxia;QIAN Jifang;LI Yunzhi;ZHANG Yanhui;XU Shengfang(Medical Imaging Center,Gansu Provincial Matemity and Child-care Hospital,Lanzhou 730050,China)

机构地区：[1]甘肃省妇幼保健院医学影像中心,兰州730050

出　　处：《磁共振成像》2023年第2期83-86,108,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：甘肃省卫生健康行业科研计划项目(编号:GSWSKY2021-059)。

摘　　要：目的探讨全肿瘤的表观扩散系数(apparent diffusion coefficient,ADC)直方图的纹理参数对鉴别卵巢上皮肿瘤良性、交界性、恶性的诊断价值。材料与方法回顾性分析2019年1月至2022年9月在甘肃省妇幼保健院经过术后病理证实为卵巢上皮肿瘤且术前在我院行常规MRI检查的患者病例71例,在Fire Voxel软件上导入ADC图并手动勾画病灶整体感兴趣区(region of interest,ROI),软件自动生成直方图纹理参数(熵、偏度、峰度、标准差、最大值、最小值、平均值)。采用单因素方差分析方法来评估ADC图各纹理参数在良性、交界性及恶性卵巢上皮肿瘤之间的差异。绘制受试者工作特征(receiver operating characteristic,ROC)曲线并计算曲线下面积(area under the curve,AUC),评估各参数对鉴别良性、交界性及恶性卵巢上皮肿瘤的诊断效能。结果在ADC图纹理参数中,熵、偏度、峰度、最大值、最小值、平均值在卵巢上皮肿瘤良性、交界性及恶性组之间差异具有统计学意义(P值分别为<0.001、0.003、<0.001、0.007、0.005、0.001)。ROC曲线分析结果显示,AUC值最大的是熵(AUC=0.75)。结论全肿瘤ADC图纹理分析的应用可以提高对良性、交界性、恶性卵巢上皮肿瘤的鉴别诊断价值,尤其是交界性与恶性的鉴别诊断,为临床提供诊断依据并且指导临床治疗。Objective:To explore the role of whole-lesion histogram analysis of apparent diffusion coefficient(ADC)in differentiating benign,borderline and malignant ovarian epithelial tumors.Materials and Methods:A retrospective analysis of 71 patients with ovarian epithelial tumors confirmed by postoperative pathology in Gansu Maternal and Child Health Hospital from January 2019 to September 2022,and patients who underwent routine MRI examination in our hospital before operation,introduced ADC sequence into Fire Voxel software and manually sketched the whole region of interest(ROI)of the lesion,and the software automatically generated histogram texture parameters(entropy,skewness,kurtosis,standard deviation,maximum,minimum,average).Single factor analysis of variance was used to evaluate the difference of texture parameters of ADC map among benign,borderline and malignant ovarian epithelial tumors.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to evaluate the diagnostic efficacy of each parameter in the differential diagnosis of benign,borderline and malignant ovarian epithelial tumors.Results:In the texture parameters of ADC map,there were significant differences in entropy,skewness,kurtosis,maximum,minimum and average among benign,borderline and malignant ovarian epithelial tumors(P<0.001,0.003,<0.001,0.007,0.005,0.001).The result of ROC curve shows that the maximum value of AUC is entropy(AUC=0.75).Conclusions:The application of ADC texture analysis of whole tumor can improve the value of differential diagnosis of benign,borderline and malignant ovarian epithelial tumors,especially the differential diagnosis of borderline and malignant tumors,and provide clinical diagnosis basis and guide clinical treatment.

关 键 词：卵巢上皮肿瘤 磁共振成像 表观扩散系数 扩散加权成像 纹理分析 鉴别诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.31[医药卫生—诊断学]