动态增强磁共振成像结合表观弥散系数在卵巢病变中的诊断价值

Diagnostic value of dynamic contrast-enhanced MRI and apparent diffusion coeffi cient for ovarian lesions

目的探讨磁共振成像(MRI)动态增强扫描(DCE-MRI)及表观弥散系数(ADC)值在卵巢病变中的诊断价值。方法回顾分析49例经术后病理证实的MRI动态增强扫描资料并测量ADC值。结果 49例卵巢病变患者中,良性39例,恶性10例。39例良性病变患者中,13例卵巢囊肿,2例卵巢囊肿合并蒂扭转,3例巧克力囊肿,6例畸胎瘤,11例囊腺瘤,1例卵泡膜瘤,1例纤维瘤,2例卵巢脓肿合并输卵管积液扩张;9例恶性病变中,7例囊腺癌,1例浸润性移行细胞癌,1例转移性肿瘤。良性病灶组ADC值平均为(2.53±0.34)×10^(-3) mm^2/s,恶性病灶组ADC值平均为(1.11±0.34)×10^(-3) mm^2/s,恶性组ADC值明显低于良性组。动态增强扫描诊断卵巢恶性肿瘤的灵敏度、特异度和准确率分别为:92.4%、80.0%及89.8%,观察者间的一致性为0.86(kappa指数),差异具有统计学意义(P<0.05)。结论MRI动态增强扫描结合ADC值在卵巢病变的诊断及良、恶性的鉴别诊断中具有重要的价值。

【Objective】To investigate the value of dynamic contrast-enhanced magnetic resonance imaging（DCE-MRI） and apparent diffusion coeffi cient（ADC） in the diagnosis of ovarian lesions.【Methods】Dynamic enhanced MRI scan data of 49 cases confi rmed by postoperative pathology were retrospectively analyzed, and the ADC values were measured.【Results】In 49 cases of ovarian lesions, 39 cases were benign and 10 cases were malignant. In 39 cases of benign lesions, there were 13 cases of ovarian cyst, 2 cases of ovarian cyst with torsion, 3 cases of chocolate cyst, 6 cases of teratoma, 11 cases of cystadenoma, 1 case of theca tumor, 1 case of fi broma and 2 cases of ovarian abscess with tubal fl uid expansion; in 9 cases of malignant lesions, there were 7 cases of cystadenocarcinoma, 1 case of invasive transitional cell carcinoma and 1 case of metastatic tumor. The average ADC value for benign lesion group was（2.53 ＋ 0.34） × 10^（-3） mm^2/s, the average ADC value for malignant lesion group was（1.11 ＋ 0.34） × 10^（-3） mm^2/s, and the ADC value of malignant group was obviously lower than that of benign group. The sensitivity, specifi city and accuracy of dynamic enhanced scan in the diagnosis of ovarian malignancy were 92.4%, 80.0% and 89.8% respectively, the consistency between the observer was 0.86（kappa index）, and the differences were statistically signifi cant（P〈0.05）.【Conclusion】Dynamic enhanced MRI combined with ADC is of important value in the diagnosis of ovarian lesions and the differential diagnosis of benign and malignant tumors.