DCE-MRI定量分析对正常卵巢及囊实性卵巢肿瘤的诊断价值研究

Value of DCE-MRI Quantitative Analysis in the Diagnosis of Normal Ovary and Cystic-solid Ovarian Tumors

目的探讨动态增强磁共振成像(DCE-MRI)定量分析对正常卵巢及囊实性卵巢肿瘤的诊断价值。方法选取2019年1月至2020年7月我院及珠江医院收治的盆腔肿块患者120例作为研究对象,所有患者入院后均采用扩散加权成像(DWI)与DCE-MRI影像常规检查,以病理结果为"金标准",比较不同检查方式在正常卵巢及囊实性卵巢肿瘤中的诊断价值。结果病理结果分析发现120例患者中有66例患者存在囊实性卵巢肿瘤,其中31例良性,10例交界性,25例恶性;另外54例为正常卵巢,其中包含29例黄体期者,25例卵泡期者;对照组的表观扩散系数(ADC)值显著高于研究组(P<0.05);对照组对比剂容积转换常数(Ktrans)、速率常数(Kep)及血管外细胞外间隙百分比(Ve)均明显低于研究组(P<0.05),DWI+DCE-MRI联合诊断在鉴别正常卵巢与囊实性卵巢肿瘤中的灵敏度、特异性、准确度、阳性预测值、阴性预测值分别为94.44%、95.45%、95.00%、94.44%、95.45%,明显高于DWI、DCEMRI单项检查(P<0.05)。结论DWI与DCE-MRI联合诊断在鉴别正常卵巢及囊实性卵巢肿瘤中效能显著优于单项检测,作为无创检查,可为提高临床对囊实性卵巢肿瘤的确诊提供有效依据。

Objective This study was aimed to investigate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging(DCE-M RI)quantitative analysis for normal ovary and cystic-solid ovarian tumors.Methods Between January 2019 and July 2020,a total of 120 patients with pelvic lumps treated in this hospital and Zhujiang Hospital were enrolled in the study.All subjects were examined by diffusion-weigh ted imaging(DWI)and DCE-MRI after admission.Taking pathological results as the golden standard,the diagnostic value of different examination methods in normal ovary and cysticsolid ovarian tumors was compared.Results Pathological results found that 66 of the 120 patients had cystic-solid ovarian tumors,including 31 cases with benign,10 cases with junctional,and 25 cases with malignant ones.The other 54 cases had normal ovaries,including 29 cases in the luteal phase and 25 cases in the follicular phase.The apparent diffusion coefficient(ADC)value of the control group was significantly higher than that of the study group(P<0.05).The volume transfer constant of the contrast agent(Ktrans),rate constant(Kep),and extravascular extracellular volume fraction(Ve)of the control group were significantly lower than those of the study group(P<0.05).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of DWI combined with DCE-MRI in distinguishing normal ova ry and cystic-solid ovarian tumors were 94.44%,95.45%,95.00%,94.44%,and 95.45%,significantly higher than those of DWI or DCE-MRI alone(P<0.05).Conclusion DWI combined with DCE-MRI is superior to each method alone in identifying normal ova ry and cysticsolid ovarian tumors.A noninvasive examination method can provide a sufficient basis for the clinical diagnosis of cystic-solid ovarian tumors.