磁共振弥散成像联合血清CA125、HE4对卵巢上皮性肿瘤的诊断价值

Diagnostic Value of MR Diffusion Weighted Imaging Combined with Serum CA125 and HE4 in Epithelial Ovarian Tumors

目的比较MR弥散成像参数ADC值、血清CA125、HE4及联合诊断对卵巢上皮性肿瘤的诊断效能。方法回顾性分析118例卵巢上皮性肿瘤患者病例,依据病理结果分为3组:恶性组17例、交界性组34例、良性组67例。在住院病历系统中检测围手术期患者血清CA125、HE4指标,分析盆腔肿瘤MRI征象、测量肿瘤实性部分ADC值。结果以术后病理结果作为金标准,恶性、交界性和良性3组血清CA125、HE4值差异具有统计学差异(P <0.001);3组肿瘤实性部分ADC值差异具有统计学差异(P <0.001)。肿瘤实性部分ADC值、CA125及HE4三者联合诊断敏感度、特异度及准确性分别为75.61%、98.39%、89.32%,高于单一指标诊断(ADC值、CA125、HE4敏感度、特异度及准确性分别为68.29%、80.00%、70.18%,58.54%、85.48%、74.76%和28.57%、97.83%、67.90%)及CA125、HE4联合诊断(敏感度、特异度及准确性分别为66.67%、95.16%、82.52%)(P <0.05)。结论联合ADC值、血清CA125、HE4三种指标可提高卵巢上皮性肿瘤诊断的敏感度、特异度与准确性。

Objective To compare the diagnostic efficiency of MR diffusion imaging parameters ADC value,serum CA125,HE4 and their combination in the diagnosis of ovarian epithelial tumors.Methods A total of 118 cases of epithelial ovarian tumor were analyzed retrospectively.The serum CA125 and HE4 of perioperative patients were collected,the MRI signs of pelvic neoplasms were analyzed,and the ADC value of tumor was measured.Results Postoperative pathological results were taken as the gold standard.The difference of serum CA125 and HE4 among malignant,borderline and benign groups were statistically significant(P<0.001).There was a statistical difference in ADC values of solid parts of tumors among the three groups(P<0.001).The sensitivity,specificity and accuracy of combined diagnosis of ADC value,CA125 and HE4 were 75.61%,98.39%and 89.32%respectively,which were higher than single index diagnosis(the sensitivity,specificity and accuracy of ADC values,CA125 and HE4 were 68.29%,80.00%,70.18%,58.54%,85.48%,74.76%and 28.57%,97.83%,67.90%,respectively)and combined diagnosis of CA125 and HE4(the sensitivity,specificity and accuracy were 66.67%,95.16%and 82.52%,respectively)(P<0.05).Conclusion The combination of ADC value,serum CA125 and HE4 can improve the diagnostic accuracy of epithelial ovarian tumor.