磁共振成像-弥散加权成像诊断良恶性卵巢肿瘤的临床价值

Magnetic resonance imaging-diffusion weighted imaging in diagnosis of benign and malignant ovarian tumors

目的探讨磁共振成像-弥散加权成像(MRI-DWI)诊断良恶性卵巢肿瘤的临床价值。方法对经手术病理确诊为卵巢占位性病变的100例患者的MRI常规扫描参数及DWI图像表现进行分析。比较良恶性病变的病变最大径、表观扩散系数(ADC)值、肿瘤位置、边界、囊实性、囊壁/分隔、T1及T2信号均匀性,并进行Logistic回归分析。绘制受试者工作特征(ROC)曲线比较各影响因素的曲线下面积(AUC)。结果100例卵巢肿瘤患者中,有69例为良性,31例为恶性,其中良性肿瘤病灶85个,恶性肿瘤病灶43个。良性肿瘤病灶与恶性肿瘤病灶的病变最大径、ADC值、囊壁/分隔、囊实性及T2信号均匀性比较,差异均有统计学意义(P﹤0.01)。ADC值与病变良恶性呈负相关(P﹤0.05),囊壁/分隔、囊实性、T2信号均匀性均是恶性病变发生的危险因素(P﹤0.01)。ADC值、囊壁/分隔、囊实性及T2信号均匀性的ROC曲线的AUC值分别为0.840、0.672、0.560、0.643,ADC值诊断良恶性卵巢肿瘤的临界值为1.65×10^(-3)mm^(2)/s,对应的灵敏度和特异度分别为92.01%、85.39%。结论卵巢恶性肿瘤的MRI-DWI图像呈现高信号,ADC值低于卵巢良性肿瘤,DWI在诊断良恶性卵巢肿瘤方面的价值高于MRI常规扫描。

Objective To explore the clinical value of magnetic resonance imaging(MRI)-diffusion weighted imaging(DWI)in the diagnosis of benign and malignant ovarian tumors.Method The routine MRI scanning parameters and DWI of 100 patients with ovarian space-occupying lesions diagnosed by operation and pathology were analyzed;the maximum diameter of the lesion,apparent diffusion coefficient(ADC),tumor location,boundary,cystic solid,cyst wall/septum,T1 and T2 signal uniformity were compared;the Logistic regresssion analysis was carried out and receiver operating characteristic(ROC)curve were drawn to compare the area under the curve(AUC)of the influencing factors.Result 69 cases were benign and 31 cases malignant,including 85 benign lesions and 43 malignant lesions among 100 patients with ovarian tumors.There were significant differences for the maximum diameter,ADC value,cyst wall/septum,cystic solid and T2 signal uniformity between benign and malignant lesions(P<0.01).ADC value was negatively correlated with benign and malignant lesions(P<0.05),and cyst wall/septum,cystic solid and T2 signal uniformity were the risk factors of malignant lesions(P<0.01).The AUC of ADC value,cyst wall/septum,cystic solid,T2 signal uniformity were 0.840,0.672,0.560,and 0.643,respectively.The critical value of ADC for the diagnosis of benign and malignant ovarian tumors was 1.65×10^(-3)mm^(2)/s,and the corresponding sensitivity and specificity were 92.01%and 85.39%,respectively.Conclusion MRI-DWI of ovarian malignant tumors show high signal intensity,and the ADC value of ovarian malignant tumors is significantly lower than that of benign ovarian tumors.The value of DWI in the diagnosis of benign and malignant ovarian tumors is higher than that of MRI.