扩散加权成像定量参数对鉴别卵巢上皮性肿瘤性质的价值  

The value of quantitative parameters of diffusion weighted imaging in differentiating the nature of ovarian epithelial tumors

作　　者：范娇娇 刘洋[1] 刘瑞超 李冠雄 谢子腾 夏伟[1] FAN Jiaojiao;LIU Yang;LIU Ruichao;LI Guanxiong;XIE Ziteng;XIA Wei(First Department of Medical Imaging,Baoding No.1 Central Hospital,Baoding,Hebei Province 071000,China)

机构地区：[1]保定市第一中心医院医学影像一科,河北保定071000

出　　处：《实用放射学杂志》2024年第9期1468-1471,1498,共5页Journal of Practical Radiology

基　　金：保定市科技计划项目(2241ZF246)。

摘　　要：目的 探讨MR扩散加权成像(DWI)定量参数最小表观扩散系数(ADCmin)、表观扩散系数差值(dADC)在鉴别卵巢上皮性良性肿瘤与Ⅰ期恶性肿瘤中的价值.方法 回顾性选取经手术病理证实的原发性卵巢上皮性肿瘤患者112例(43例良性肿瘤,69例Ⅰ期恶性肿瘤),术前行常规MRI平扫及DWI检查.测量并比较2组肿瘤实性部分的ADCmin和dADC.利用logistic回归分析及受试者工作特征(ROC)曲线评估各参数单独及联合应用鉴别卵巢上皮性良性肿瘤与Ⅰ期恶性肿瘤的效能.结果 卵巢上皮性良性肿瘤实性部分的ADCmin大于Ⅰ期恶性肿瘤,而dADC小于T期恶性肿瘤(P<0.05).logistic回归分析显示ADCmin、dADC为Ⅰ期恶性肿瘤的独立危险因素.ROC曲线分析显示,当ADCmin、dADC的最佳诊断阈值分别为1.183 × 10^(-3) mm^(2)/s、0.579×10^(-3)mm^(2)/s时曲线下面积(AUC)分别为0.802、0.857,诊断敏感度、特异度分别为0.885、0.808、0.714、0.857;当联合ADCmin、dADC建立回归模型logit(P)=7.154+0.267 × dADC-1.016 × ADCmin时,AUC为0.951,诊断效能大于各单一参数,其敏感度为0.890,特异度为0.995.结论 ADCmin、dADC对术前准确鉴别卵巢上皮性良性肿瘤与Ⅰ期恶性肿瘤有一定价值,且ADCmin联合dADC可以提高术前诊断的准确性.Objective To investigate the value of minimum apparent diffusion coefficient(ADCmin)and delta apparent diffusion coefficient(dADC)of quantitative parameters of MR diffusion weighted imaging(DWI)in differentiating benign from stageⅠmalignant ovarian epithelial tumors.Methods A total of 112 patients with primary ovarian epithelial tumors confirmed by operation and pathology(43 benign tumors and 69 stage Ⅰ malignant tumors)were retrospectively selected.All patients underwent routine MRI and DWI before operation.The ADCmin and dADC of solid portion were measured and compared between the two groups.Logistic regression anal-ysis and receiver operating characteristic(ROC)curve were used to evaluate diagnostic performance of each parameter alone and in combination in differentiating ovarian epithelial benign and stageⅠmalignant tumors.Results The ADCmin was greater in benign tumors than that in stageⅠmalignant tumors,while dADC was smaller in benign tumors than that in stageⅠmalignant tumors(P<0.05).Logis-tic regression analysis showed that ADCmin and dADC were independent risk factors for stageⅠmalignant tumors.With threshold of 1.183 × 10^(-3)mm^(2)/s for ADCmin and 0.579 × 10^(-3)mm^(2)/s for dADC,the area under the curve(AUC)was 0.802 and 0.857,sensitivity and specificity of 0.885,0.808,0.714,0.857,respectively.According to regression equation logit(P)=7.154+0.267×dADC-1.016×ADCmin,the AUC(0.951)was greater than that of single parameter,the sensitivity was 0.890,the specificity was 0.995.Conclusion ADCmin and dADC are useful for differentiating ovarian epithelial benign from stageⅠmalignant tumors,and ADCmin combined with dADC can improvethediagnoseaccuracy beforeoperation.

关 键 词：卵巢上皮性肿瘤 表观扩散系数 LOGISTIC回归 

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