基于3.0T MRI对卵泡膜纤维瘤与阔韧带平滑肌瘤的鉴别诊断

The value of 3.0T MRI in the differential diagnosis of ovarian fibrothecoma and broad ligament leiomyoma

目的探讨3.0T MRI对卵泡膜纤维瘤与阔韧带平滑肌瘤的鉴别诊断价值。方法收集经病理证实的15例卵泡膜纤维瘤和38例阔韧带平滑肌瘤,采用单因素对比和多因素回归分析两者的临床资料(月经情况、临床症状)、肿瘤大小、腹水、病变侧卵巢存留率、子宫内膜厚度、MRI信号、强化程度及肿瘤成分特征。结果两组间病变侧卵巢存留率、ADC值、强化程度及肿瘤成分的差异具统计学意义(P<0.05)。两组间临床资料、肿瘤大小、腹水、子宫内膜厚度、MRI平扫信号的差异无统计学意义。多因素回归结果示ADC值、强化程度是鉴别两者的重要预测因子,该回归模型的ROC曲线下面积(AUC)为0.908,灵敏度、特异度及约登指数分别为93.3%、73.7%和0.720。结论卵泡膜纤维瘤与阔韧带平滑肌瘤的病变侧卵巢存留情况、ADC值、强化程度及肿瘤成分有助于两者的鉴别诊断。

Objective To explore the differential diagnostic value of 3.0 T magnetic resonance imaging/MRI between ovarian fibrothecoma and broad ligament leiomyoma.Methods15 cases of ovarian fibrothecoma and38 cases of broad ligament leiomyoma with pathologically confirmed were collected in this study.The clinical infor-mation(menstrual history,clinical symptoms),tumorous size,ascites,visibility of ipsilateral ovarian,endometri-al thickness,MRI signal characters(appearance on T1-weighted,T2-weighted and diffusion-weighted imaging,andapparent diffusion coefficient/ADC),enhanced degree and tumorous component were retrospectively analyzed fromthe contrastive analysis and multiple-factor regression analysis.ResultsThe results of contrastive analysis showedthat the differences in visibility of ipsilateral ovarian,ADC value,enhanced degree and tumorous component,reached statistically significant levels(P<0.05).The differences in clinical data,tumorous size,ascites,endo-metrial thickness and MRI signal characters(T1-weighted,T2-weighted and diffusion-weighted imaging)were notstatistically significant between the two groups.The results of multiple-factor regression analysis showed that theADC value and enhanced degree were important predictive factors.The area under the receiver operating character-istic curve of 53 cases was 0.908.And the sensitivity,specificity and yoden index were 93.3%,73.7%and 0.720,respectively.ConclusionThere are many overlaps between ovarian fibrothecoma and broad ligament leiomyomaon MRI plain scan,but there are different characteristics in visibility of ipsilateral ovarian,ADC value,enhanceddegree and tumorous component,which are helpful for the differential diagnosis of the ovarian fibrothecoma andbroad ligament leiomyoma.