磁共振联合血清糖类抗原125在诊断鉴别卵巢肿瘤良恶性中的应用

Application of MRI combined with serum CA125 in differential diagnosis of benign and malignant ovarian tumors

目的探讨磁共振成像(MRI)联合血清糖类抗原125(CA125)在诊断鉴别卵巢肿瘤良恶性中的应用价值。方法2014年12月至2016年12月我院114例卵巢肿瘤患者,其中恶性卵巢肿瘤37例(恶性组),良性卵巢肿瘤77例(良性组),分析两组临床特征、血清CA125水平及MRI表现差异,并与病理结果对照,评价MRI联合血清CA125检测对卵巢肿瘤定性诊断的敏感度、特异度、准确度及阳性预测值。结果恶性卵巢肿瘤MRI表现:多数出现双侧病灶,成分为囊实性或实性,形状多不规则,边界多不清楚,均呈明显强化;良性卵巢肿瘤MRI表现:主要为单侧病灶,以囊性成分为主,形态多规则,边界清楚,无强化或呈轻度强化。两组病灶分布、边界、形态、成分、强化程度等比较差异有统计学意义(P<0.05);恶性肿瘤血清CA125水平明显高于良性肿瘤(P<0.05)。MRI联合血清CA125检测鉴别卵巢肿瘤良恶性的敏感度、特异度、准确度、阳性预测值明显优于单一MRI检查或CA125水平检测(P<0.05)。结论 MRI联合血清CA125鉴别卵巢肿瘤良恶性具有较高敏感度、特异度及准确度,优于单一MRI检查或血清CA125水平检测。

To explore the application value of magnetic resonance imaging(MRI)combined with serum carbohydrate antigen 125(CA125)in differential diagnosis of benign and malignant ovarian tumors.We selected 114 patients with ovarian tumor in our hospital from December 2014 to December 2016 in which there were 37 malignant ovarian tumors(malignant group)and 77 benign ovarian tumors(benign group).The clinical features,serum CA125 levels and MRI manifestations were analyzed to compare the pathological findings.Finally,the sensitivity,specificity,accuracy and positive predictive value of combination of MRI with serum CA125 were evaluated in the diagnosis of ovarian tumors.The mainly features of MRI of malignant ovarian tumors showed the bilateral lesions,cystic solid or solid composition,irregular shape,unclear boundaries and obvious enhancement.The mainly features of MRI of benign ovarian tumor showed the unilateral lesions,cystic composition,multiple shapes,clear boundaries and no enhancement or mild enhancement.There were significant differences in the lesion distribution,border,shape,composition and degree of enhancement between the two groups(P<0.05).The serum levels of CA125 in the malignant group were significantly higher than that in the benign group(P<0.05).The sensitivity,specificity,accuracy and positive predictive value of MRI combined with serum CA125 in differentiate diagnosis of benign and malignant ovarian tumors were significantly better than MRI or CA125 alone.MRI combined with serum CA125 has good sensitivity,specificity and accuracy in identifying benign and malignant ovarian tumors,which is superior to the use of MRI or serum CA125 alone.