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效果分析

Analysis of Dynamic Contrast-enhanced Magnetic Resonance Imaging Combined with Apparent Diffusion Coefficient for Diagnosis of Ovarian Lesions Patients

目的探讨动态增强磁共振成像(DCE-MRI)定量参数结合表观弥散系数(ADC)在卵巢病变中的诊断价值。方法回顾性分析2014年5月~2017年1月于我院就诊的142例卵巢病变患者临床资料,根据病理诊断结果将其分为卵巢恶性肿瘤组和卵巢良性肿瘤组。比较两组患者DCE-MRI定量参数[容量转移常数(Ktrans)、速率常数(Kep)、血管外细胞外容积分数(Ve)]及扩散加权成像(DWI)ADC值检测结果的差异,经受试者工作曲线(ROC曲线)分析DCE-MRI定量参数及ADC值在卵巢病变良恶性鉴别中的诊断效能。结果病理检查确诊卵巢良性肿瘤88例(92个肿块),卵巢恶性肿瘤54例(60个肿块)。卵巢恶性肿瘤组Ktrans、Kep、Ve等DCE-MRI定量参数值均明显高于卵巢良性肿瘤组,ADC值则明显低于卵巢良性肿瘤组,差异均有统计学意义(P<0.05)。ROC曲线显示,Ktrans、Kep值在卵巢病变良恶性鉴别诊断中特异度高但敏感度较低,Ve、ADC值则敏感度高、特异度低,差异有统计学意义(P<0.05)。结论 DCE-MRI和DWI检查在卵巢病变的良恶性鉴别诊断中均有较高应用价值,临床可将其结合使用,为治疗方案的确定提供依据。

Objective To investigate the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined withapparent diffusion coefficient(ADC)in the diagnosis of ovarian lesions.Methods The clinical data of142patients with ovarian lesionstreated in the hospital from May2014to January2017were retrospectively analyzed.The patients were divided into the ovarian malignanttumor group and ovarian benign tumor group according to the results of pathological diagnosis.The DCE-MRI quantitative parameters[volumetransfer constant(Ktrans),rate constan(Kep),extracellular volume fraction(Ve)]and the ADC value of diffusion weighted imaging(DWI)werecompared between the two groups.The diagnostic efficiency of DCE-MRI quantitative parameters and ADC value in the differential diagnosisof benign and malignant ovarian lesions were analyzed by receiver operating curve(ROC curve).Results88ovarian benign tumor patients(92masses)and54malignant tumor patients(60masses)were diagnosed by pathological examination.DCE-MRI quantitative parameterssuch as Ktrans,Kep and Ve in ovarian malignant tumor group were significantly higher than those in ovarian benign tumor group(P<0.05),while ADC value was significantly lower than that in ovarian benign tumor group(P<0.05).ROC showed that the specificity of Ktrans and Kepwas high but the sensitivity was low in the differential diagnosis of ovarian benign and malignant lesions.The sensitivity of Ve and ADC washigh but the specificity was low(P<0.05).Conclusion Both DCE-MRI and DWI are of high application value in the differential diagnosis of ovarian benign and malignant lesions.The combined application can provide the basis for clinical diagnosis and treatment.