DWI在卵巢交界性肿瘤与Ⅰ期卵巢癌中的鉴别诊断价值

The Value of DWI in Differential Diagnosis of Borderline Ovarian Cancer and Stage Ⅰ Ovarian Cancer

目的:探讨DWI序列弥散系数(ADC)值在卵巢交界性肿瘤(borderline ovarian tumors,BOTs)与Ⅰ期卵巢癌(malignant epithelial ovarian tumors,MEOTs)中的鉴别诊断价值。方法:分析在本院行多b值DWI序列检查的BOTs患者18例(20病灶)及Ⅰ期MEOTs患者 20例ADC图中实性成分的平均ADC值(ADCmean),对比不同b值条件下ADCmean值的差异,并以术后病理结果为金标准绘制ROC曲线,然后计算其曲线下面积(AUC),对比不同b值对应ADCmean值在BOTs与Ⅰ期MEOTs中的诊断价值。结果:BOTs和MEOTs的ADCmean值均随着b值的上升而下降,并且BOTs和MEOTs不同b值的ADCmean值比较,差异均有统计学意义(P<0.05)。b值为200、600、1 000 s/mm^2时,其AUC分别为0.879、0.890、0.914,当取b值为1 000 s/mm^2时诊断效能最佳,最佳阈值为1.215×10^-3 mm^2/s,诊断的敏感度、特异度、阳性预测值、阴性预测值、准确率分别为90.0%、85.0%、85.7%、89.4%、87.5%。结论:DWI序列ADC值在BOTs与Ⅰ期MEOTs的鉴别诊断中发挥一定价值,当取b值为1 000 s/mm2时诊断效能最佳。

Objective:To explore the value of apperant diffusion coefficient (ADC) value of diffusion-weighted imaging (DWI) sequence in the differential diagnosis of BOTs and stage Ⅰ MEOTs.Method:The average ADC value (ADCmean) from 18 cases (20 lesions) BOTs patients and 20 cases stage Ⅰ MEOTs patients who underwent DWI with multi b-value in our hospital were analyzed,the difference of ADCmean under different b-value conditions was compared,and the ROC curve was drawn with pathology as the gold standard to calculate the area under the curve (AUC),and the diagnostic value of ADCmean corresponding to different b-value in ovarian borderline tumor and stage Ⅰ ovarian cancer was compared.Result:The ADCmean values of both BOTs and MEOTs decreased with the increase of b value,and the differences between the ADCmean values of BOTs and MEOTs with different b values were statistically significant (P<0.05).When the b-values were 200 s/mm2,600 s/mm^2 and 1 000 s/mm2,the AUC was 0.879,0.890 and 0.914 respectively;when the b-value was 1 000 s/mm2,the diagnostic efficiency was the best,the best threshold was 1.215×10^-3 mm^2/s,and the accuracy of the sensitivity specificity were 90.0%,85.0%,85.7%,89.4% and 87.5% respectively.Conclusion:DWI sequence ADC value plays a certain value in the differential diagnosis between BOTs and stage MEOTs,and the diagnostic efficiency is best when the b-value is 1 000 s/mm^2.