表观扩散系数对卵巢浆液性癌亚型的鉴别诊断价值

Value of differential diagnosis in ovarian serous carcinoma subtypes with apparent diffusion coefficient

目的:探讨磁共振扩散加权成像的表观扩散系数(ADC)值对低级别和高级别浆液性卵巢癌的鉴别价值。方法:回顾性分析本院38例经组织病理学证实的卵巢浆液性癌的MRI资料。MR图像经两名放射科医生联合阅片。ADC值测量经一名技师分别采用小圆形ROI法和最大层面积ROI法在独立工作站上进行。比较低级别浆液性卵巢癌(LGSC)和高级别浆液性卵巢癌(HGSC)的组间ADC值差异,同时评价测量一致性。分析两组间ADC值与Ki-67表达的相关性。结果:不同组别的ADC值测量一致性均较好,小圆形ROI法获得的ADC值测量一致性要优于最大层面积法。LGSC组与HGSC组的ADCmean、ADCmin、ADCmax和ADCarea差异均具有统计学显著意义(P<0.001)。总体浆液性卵巢癌的ADCarea与Ki-67表达呈负相关(r=-0.382,P=0.02),但在各亚组别则不具有相关性。ADCmin阈值为860×10-3mm2/s时诊断HGSC的AUC为0.967。结论:ADC值可用于鉴别卵巢浆液性癌鉴别。小圆形ROI法较最大层面积法ROI操作容易、简单。ADCmin对LGSC与HGSC的鉴别诊断效能最高。

Objective:To investigate the value of apparent diffusion coefficient(ADC)of diffusion weighted magnetic resonance imaging(DWI)in differentiating low-grade and high-grade serous ovarian cancer.Methods:The MRI data of 38 cases of serous ovarian carcinoma confirmed by histopathology in our hospital were retrospectively analyzed.MR images were reviewed by two radiologists.The ADC values were measured by a technician using the small circle ROI method and maximum area ROI method on a separate workstation.The ADC differences between low-grade serous ovarian cancer(LGSC)and high-grade serous ovarian cancer(HGSC)group were compared;the repeatability of ADC measurement was also evaluated between twice measurements.The correlation between ADC value and Ki-67 expression between the two groups was analyzed.Results:The measurement consistency of ADC values of different groups was good,and the measurement consistency of ADC values obtained by the small circle ROI method was better than that by the maximum area ROI method.There were statistically significant differences in ADCmean、ADCmin、ADCmax and ADCarea between LGSC group and HGSC group(P<0.001).There was a negative correlation between ADCarea and Ki-67 expression in overall serous ovarian cancer(r=-0.382,P=0.02),but there was no correlation in each subgroup.When the ADCmin threshold was 860×10-3mm2/s,the AUC of HGSC diagnosis was 0.967.Conclusion:ADC value can be used to differentiate ovarian serous carcinoma.The small circle ROI method is easier and simpler than that of the maximum area ROI method.ADCmin was the most effective in the differential diagnosis of LGSC and HGSC.