磁共振动态增强联合扩散加权成像在卵巢肿瘤临床诊断及复发评估中的应用价值

Application value of dynamic enhanced magnetic resonance combined with diffusion weighted imaging in the clinical diagnosis and recurrence assessment of ovarian tumors

目的探讨磁共振动态增强联合扩散加权成像(DWI)在卵巢肿瘤临床诊断及复发评估中的应用价值。方法回顾性选择2018年5月至2021年4月三二〇一医院收治的63例卵巢肿瘤患者作为研究对象,均给予磁共振动态增强联合DWI,判定影像学特征。测定表观扩散系数(ADC)、病灶血流量(BF)、平均通过时间(MTT)、血容量(BV)、达峰时间(TTP)等指标。随访复发情况并评估相关性。结果在63例患者中,病理诊断为卵巢癌23例(卵巢癌组),卵巢良性肿瘤40例(良性组)。卵巢癌组轴位、矢状位、冠状位的T2WI信号特征与良性组对比差异有统计学意义(P<0.05)。卵巢癌组的ADC值为(2.11±0.14)×10^(-3)mm^(2)/s,低于良性组[(2.65±0.11)×10^(-3)mm^(2)/s],差异有统计学意义(P<0.05)。卵巢癌组的TTP为(35.46±2.22)s,高于良性组[(30.55±3.72)s],BF为(476.13±13.24)mL/100 g,低于良性组[(589.13±14.11)mL/100 g],差异均有统计学意义(P<0.05),两组BV与MTT对比差异无统计学意义(P>0.05)。在63例患者中,磁共振动态增强判断为卵巢癌21例,卵巢良性肿瘤42例;DWI判断为卵巢癌22例,卵巢良性肿瘤41例。磁共振动态增强联合DWI判断为卵巢癌23例,卵巢良性肿瘤40例,联合诊断的敏感性与特异性都为100.0%。随访到2021年11月,63例患者中复发8例,其中卵巢癌复发6例,卵巢肿瘤复发2例,复发率为18.6%。Spearsman分析显示,卵巢肿瘤复发与ADC、TTP、BF等存在相关性(P<0.05)。结论磁共振动态增强联合DWI在卵巢肿瘤的临床诊断中都具有很好的价值,能准确反映病灶的特征,可有效评估肿瘤复发情况,具有很好的应用价值。

Objective To explore the application values of magnetic resonance(MR)dynamic enhancement combined with diffusion weighted imaging(DWI)in the clinical diagnosis and recurrence assessment of ovarian tumors.Methods A total of 63 ovarian tumor patients admitted to 3201 Hospital from May 2018 to April 2021 were retrospectively selected as the research subjects.All patients were given MR dynamic enhancement combined with diffusion-weighted imaging,all the patients were to determine the imaging characteristics.Indexes such as apparent diffusion coefficient(ADC),focal blood flow(BF),mean transit time(MTT),blood volume(BV),and time to peak(TTP)were determined.Followed up the recurrence and assessed the correlation.Results In the 63 patients,there were 23 patients were pathologically diagnosed as ovarian cancer(ovarian cancer group),and 40 patients were benign ovarian tumors(benign group).The axial,sagittal,and coronal T2WI signal characteristics of the ovarian cancer group were significantly different from those of the benign group(P<0.05).The ADC value of ovarian cancer group was(2.11±0.14)×10^(-3)mm^(2)/s,which was lower than that of benign group[(2.65±0.11)×10^(-3)mm^(2)/s],and the difference was statistically significant(P<0.05).The TTP of the ovarian cancer group was(35.46±2.22)s,which was higher than that of the benign group[(30.55±3.72)s],and the BF was(476.13±13.24)mL/100 g,which was lower than that of the benign group[(589.13±14.11)mL/100 g],the differences were statistically significant(P<0.05).There was no significant difference in BV and MTT between the two groups(P>0.05).In the 63 patients,there were 21 cases of were ovarian cancer and 42 cases of benign ovarian tumors were judged by MRI dynamic enhancement;and there were 22 cases of were ovarian cancer and 41 cases of benign ovarian tumors were judged by diffusion-weighted imaging.MRI dynamic enhancement combined with diffusion-weighted imaging judged 23 cases of ovarian cancer and 40 cases of ovarian benign tumors.The sensitivity and specificity of the combined diagnosis were both 100.0%.Followed-up until November 2021,there were 8 patients of the 63 patients were recurred,included 6 patients were ovarian cancer recurrence and 2 patients of ovarian tumor recurrence,with the recurrence rate of 18.6%.Spearsman analysis showed that ovarian tumor recurrence were correlated with ADC,TTP,BF,etc(P<0.05).Conclusion MR dynamic enhancement combined with diffusion-weighted imaging have very good value in the clinical diagnosis of ovarian tumors,can accurately reflect the characteristics of the lesion,can effectively evaluate the tumor recurrence,and have good application value.