DCE-MRI联合高b值DWI对卵巢上皮性肿瘤良性、交界性及恶性的鉴别诊断价值分析  

DCE-MRI and High-b-value DWI for differentiating benign,borderline and malignant ovarian epithelial tumor

作　　者：刘碧英[1] 兰浩敏 陈瑞烟 张祝辉 何岩燕 张小镇 LIU Biying;LAN Haomin;CHEN Ruiyan;ZHANG Zhuhui;He Yanyan;ZHANG Xiaozhen(Department of Radiology,the People's Hospital of Fujian Traditional Chinese Medicine University,Fuzhou 350005,China)

机构地区：[1]福建中医药大学附属人民医院放射科,福建福州350005

出　　处：《医学影像学杂志》2024年第1期82-86,共5页Journal of Medical Imaging

基　　金：福建省科技厅科技项目(编号:2018Y0045)。

摘　　要：目的探讨DCE-MRI联合高b值DWI对卵巢上皮性肿瘤良性、交界性、恶性的鉴别诊断价值。方法选取病理证实为卵巢上皮性肿瘤患者55例,其中良性23例(良性组),交界性10例(交界性组),恶性22例(恶性组);术前行MRI平扫及增强、高b值DWI(b值=1200s/mm^(2))、DCE-MRI定量分析,并行统计学分析确定最佳最大阈值。结果1)良性组和恶性组A1及Ktrans值、Kep值及Ve值各组间差异均有统计学意义(P<0.05);恶性组和交界性组肿瘤A1及Kep值各组间差异均有统计学意义(P<0.05);2)ROC曲线分析,良、恶性组A1值的诊断阈值为1179.4 mm^(2)/s,AUC为0.945,Ktrans值具有最高的诊断效能,诊断阈值为0.0823min^(-1),AUC为0.913;交界性组与恶性组A1值的诊断阈值为1147.8 mm^(2)/s,AUC为0.891,Kep值AUC为0.732,诊断阈值为0.273 min^(-1);3)高b值DWI联合DCE-MRI对卵巢良性组和恶性组肿瘤鉴别及恶性组和交界性组肿瘤鉴别诊断具有高诊断效能。结论1)高b值及Ktrans值在卵巢上皮性肿瘤良性组和恶性诊断中具有高诊断效能;高b值及Kep值在卵巢上皮性恶性组和交界性肿瘤诊断中具有高诊断效能。2)高b值DWI、DCE-MRI联合筛查明显提高了卵巢上皮性肿瘤术前诊断的正确性。Objective To investigate the potential value of dynamic contrast enhanced-MR imaging(DCE-MRI)and high-bvalue diffusion weighted imaging(DWI)for differentiating benign,borderline and malignant ovarian epithelial tumor and to evaluate whether the preoperative diagnostic performance can be improved when combining two techniques.Methods This retrospectively study enrolled 55 patients with ovarian epithelial tumor confirmed by pathology.All patients underwent conventional MR imaging,high-b value DWI and DCE-MRI.The apparent diffusion coefficient(ADC)values were obtained from solid of tumor,while,Ktrans,Kep and Ve values were obtained from the solid portion of tumor.Receiver operating characteristic(ROC)curve analysis was performed to determine optimal thresholds,sensitivity(Se),specificity(Sp),positive predictive value(PPV),negative predictive value(NPV)and accuracy(ACC)for ADC,Ktrans,Kep and Ve values in the differentiation of benign,borderline and malignant ovarian epithelial tumor.Results 1)There were significant differences in A1,Ktrans,Kep and Ve values of solid portion between benign and malignant.There was significant difference in Ktrans value of solid portion between benign and borderline.There were significant differences in A1,Kep values of solid portion between borderline and malignant.2)In ROC curve analysis,A1 values provided a valuable diagnostic performance in differentiating malignant from benign ovarian epithelial tumor:AUC=0.945 of solid portion with optimal thresholds,Se,Sp,PPV and NPV of 1149.9 mm^(2)/s,95.7%,95.5%,95.5% and 95.7%,correspondingly.Beside,the AUC of Ktrans values(AUC=0.913)was higher than that of Kep or Ve values,with optimal thresholds,Se,Sp,PPV and NPV of 0.0823 min^(-1),90.9%,82.6%,83.9%,and 94%.A1 values provided a valuable diagnostic performance in differentiating malignant from borderline ovarian epithelial tumor:AUC=0.891 of solid portion with optimal thresholds,Se,Sp,PPV and NPV of 1149.9 mm^(2)/s,80%,95.5%,94.7% and 82.7%.Beside,the AUC of Kep values(AUC=0.732)was higher di

关 键 词：磁共振成像 卵巢上皮性肿瘤 

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