DCE-MRI在卵巢交界性肿瘤与上皮性卵巢癌中的鉴别诊断价值

The value of DCE-MRI in the differential diagnosis of borderline and malignant epithelial ovarian tumors

目的探讨动态增强磁共振成像(DCE-MRI)对交界性与恶性上皮性卵巢肿瘤中的鉴别诊断价值。方法选取我院收治的交界性上皮性卵巢肿瘤(BEOT)患者22例与恶性上皮性卵巢肿瘤(MEOT)患者38例资料,均行卵巢常规磁共振成像(MRI)及DCE-MRI检查,经过处理后获得半定量参数,比较两组卵巢肿瘤患者的半定量参数水平,采用受试者工作特征(ROC)曲线分析DCE-MRI半定量参数对交界性与恶性上皮性卵巢肿瘤的鉴别诊断价值。结果在常规MRI病灶检查中,MEOT组病灶肿块类型以囊实性为主,而BEOT组病灶以囊性为主,且两组患者均多见单侧、中度强化程度,少见腹盆腔积液。两组患者在肿块类型、强化程度、单双侧及腹盆腔积液指标上差异无统计学意义(P>0.05)。MEOT患者的Cmax、AUC及MS值显著高于BEOT组,而TTP值却显著低于BEOT组(P<0.05)。TTP、Cmax、AUC及MS的曲线下面积分别为0.255、0.761、0.748、0.790,最佳临界值分别为3.576s、0.170mmol/L、0.547、0.285,敏感度分别为52.6%、78.4%、87.5%、72.8%,特异度分别为78.8%、62.7%、52.2%、56.0%。结论DCE-MRI半定量参数Cmax、AUC及MS对MEOT及BEOT具有较高的鉴别诊断价值,其中MS值的诊断价值最高。

Objective To investigate the value of dynamic enhanced magnetic resonance imaging(DCE-MRI)in the differential diagnosis of borderline and malignant epithelial ovarian tumors.Methods Twenty-two patients with borderline epithelial ovarian tumor(BEOT)and 38 patients with malignant epithelial ovarian tumor(MEOT)treated in our hospital from July 2017 to July 2019 were retrospectively analyzed.All patients underwent conventional ovarian magnetic resonance imaging(MRI)and DCE-MRI.Semi-quantitative parameters were obtained after treatment,and the semi-quantitative parameter levels of the two groups of ovarian tumor patients were compared.The receiver operating characteristic(ROC)curve was used to analyze the DCE-MRI semi-quantitative parameters for the differential diagnosis of borderline and malignant epithelial ovarian tumors.Results In conventional MRI lesions,the lesion type in the MEOT group was mainly cystic,while the lesion in the BEOT group was mainly cystic,and both groups had more unilateral and moderate enhancement,and less peritoneal effusion.There were no significant differences in the types of tumors,the degree of enhancement,unilateral and bilateral peritoneal effusion in the two groups(P>0.05).The Cmax,AUC,and MS values of MEOT patients were significantly higher than those of the BEOT group,while the TTP values were significantly lower than those of the BEOT group(P<0.05).The areas under the curve of TTP,Cmax,AUC,and MS were 0.255,0.761,0.748,0.790,respectively;the optimal cutoffs were 3.576s,0.170 mmol/L,0.547,0.285,respectively;the sensitivity was 52.6%,78.4%,87.5%,72.8%,respectively;and the specificity was 78.8%,62.7%,52.2%,56.0%,respectively.Conclusion The semi-quantitative parameters Cmax,AUC and MS of DCE-MRI have higher differential diagnosis value for MEOT and BEOT,among which MS value has the highest diagnostic value.