动态增强磁共振成像对良恶性卵巢肿瘤的鉴别诊断价值

Clinical significance of dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of benign and malignant ovarian tumors

目的 探讨动态增强磁共振成像对良恶性卵巢肿瘤的鉴别诊断价值.方法 选择病理诊断为良性卵巢肿瘤患者50例作为良性组、恶性卵巢肿瘤患者50例为恶性组,所有患者进行动态增强磁共振成像扫描.结果 良性组时间信号曲线（TIC）曲线构成比和恶性组差异有统计学意义（P〈0.05）,良性组以Ⅰ型曲线为主,恶性组以Ⅲ型曲线为主.良性组卵巢肿瘤的Ve值、Kep值、Ktrans值[（0.492±0.227）、（0.163±0.081）min-1、（0.071±0.034）min-1]均低于恶性组[（0.686±0.153）、（0.411±0.214）min-1、（0.282±0.110）min-1]（P〈0.05）.Ve值、Kep值、Ktrans值鉴别卵巢良恶性的ROC曲线下面积分别为0.707、0.942、1.000;根据计算约登指数得出Ve、Kep、Ktrans对卵巢良恶性肿瘤的最佳鉴别阈值分别为0.118 min-1、0.257 min-1、0.546;Ve诊断卵巢良恶性肿瘤的约登指数、灵敏度、特异度、阳性预测值、阴性预测值分别为0.446、88.84％、57.23％、63.24％、86.12％;Kep诊断卵巢良恶性肿瘤的约登指数、灵敏度、特异度、阳性预测值、阴性预测值分别为0.804、88.91％、90.87％、89.15％、90.78％;Ktrans诊断卵巢良恶性肿瘤的约登指数、灵敏度、特异度、阳性预测值、阴性预测值分别为1.000、100.0％、100.0％、100.0％、100.0％.结论 动态增强磁共振成像对良恶性卵巢肿瘤具有鉴别诊断价值,卵巢良性肿瘤以Ⅰ型曲线为主,卵巢恶性肿瘤以Ⅲ型曲线为主,Ktrans对卵巢良恶性肿瘤的鉴别诊断效能最佳.

Objective To explore the value of dynamic contrast -enhanced magnetic resonance imaging in differential diagnosis of benign and malignant ovarian tumors .Methods 50 patients with benign ovarian cancer were selected as the benign group ,and 50 patients with malignant ovarian cancer were selected as the malignant group .All patients underwent dynamic contrast-enhanced magnetic resonance imaging .Results The difference of the time intensity curve （ TIC） curve between the benign group and the malignant group was no statistically significant （ P〈0.05）,the benign group was mainly type Ⅰ curve,and the malignant group was dominated by type Ⅲ curve.The values of Ve,Kep and Ktrans in the benign ovarian tumors [（0.492 ±0.227）,（0.163 ±0.081）min-1,（0.071 ± 0.034） min-1 ] were significantly lower than those in the malignant group [（ 0.686 ±0.153 ）, （ 0.411 ± 0.214）min-1,（0.282 ±0.110）min-1]（P〈0.05）.The ROC curve under the area of Ve value,Kep value,Ktrans value to identify ovarian benign and malignant were 0.707,0.942,1.000;the best differential value of Ve ,Kep, Ktransfor ovarian benign and malignant tumors were 0.118min-1,0.257min-1,0.546,respectively.The Jorden index,sensitivity,specificity,positive predictive value,negative predictive values of the diagnosis of the ovarian benign and malignant tumors were 0.446,88.84％,57.23％,63.24％and 86.12％,respectively.The Jorden index,sensitivity, specificity,positive predictive value ,negative predictive values of Kep in the diagnosis of ovarian benign and malignant tumors were 0.804,88.91％,90.87％,89.15％and 90.78％,respectively.The Jorden index,sensitivity,specificity, positive predictive value ,negative predictive values of Ktrans in the diagnosis of ovarian benign and malignant tumors were 1.000,100.0％,100.0％,100.0％,100.0％.Conclusion Dynamic contrast -enhanced magnetic resonance imaging has differential diagnosis value on benign and malignant ovarian tumors .The ovarian benign tumors are mainly type Ⅰcurve,and the ovarian malignant tumors is mainly type Ⅲcurve.Ktrans is the best for differential diagnosis of ovarian benign and malignant tumors .