磁共振扩散加权成像ADC值在女性盆腔良恶性肿瘤鉴别诊断中的应用

The value of diffusion weighted magnetic resonance imaging ADC in the differential diagnosis of benign and malignant pelvic tumors in women

目的 探讨磁共振扩散加权成像表现扩散系数(ADC)值用于女性盆腔良恶性肿瘤鉴别诊断中的价值。方法 选取2018年1月—2021年1月浙江中医药大学附属第三医院收治的120例女性盆腔肿瘤患者作为研究对象,均采用磁共振扩散加权成像检查,以手术病理结果作为参照计算诊断效能。同时b值取0、50、300、600、800、1 200 s/mm^(2),利用FUNctool-MADC软件处理记录良恶性病变的ADC值,并分析影像学特征。结果 经手术病理诊断,120例患者中良性肿瘤9例,恶性肿瘤111例,分别占比7.5%、92.5%。经磁共振扩散加权成像诊断,灵敏度为94.6%,特异度为77.8%,准确度为93.3%,阳性预测值为98.1%,阴性预测值为53.8%。经磁共振扩散加权成像诊断,良性肿瘤检出率为77.8%,其中子宫肌瘤检出率为66.7%,卵巢囊肿、巧克力囊肿、卵巢囊腺瘤、输卵管系膜囊肿及子宫内膜异位检出率均为100.0%。恶性肿瘤检出率为94.6%,其中宫颈癌、子宫内膜癌及卵巢癌检出率分别为97.6%、90.0%、96.7%。良恶性肿瘤间SlowADC、StandardADC比较,差异均有统计学意义(均P<0.05),FastADC、FractionADC比较,差异均无统计学意义(均P>0.05),影像学特征有相似之处,良性、恶性肿瘤颜色分别呈红色、蓝色。结论 磁共振扩散加权成像对女性盆腔良恶性肿瘤鉴别有一定价值,影像学特征有相似之处,其中SlowADC、StandardADC更为接近,可为疾病临床诊疗提供参考。

Objective To evaluate the value of diffusion weighted magnetic resonance imaging(DWI) ADC in differential diagnosis of benign and malignant pelvic tumors in women.Methods A total of 120 female patients with pelvic tumor admitted to our hospital from January 2018 to January 2021 were selected as the study subjects.All patients were examined by diffusion weighted magnetic resonance imaging(DWI),and the surgical pathological results were used as reference to calculate the diagnostic efficacy.At the same time, the B values were 0,50,300,600,800,1200 s/mm^(2),and the FUNCTool-MADC software was used to process and record the ADC values of benign and malignant lesions and analyze the imaging characteristics.Results(1) among the 120 patients diagnosed by surgery, 9 were benign tumor and 111 were malignant tumor, accounting for 7.5% and 92.5% respectively.(2) The sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 94.6%,77.8%,93.3%,98.1% and 53.8% respectively.(3) The positive rate of benign tumor was 77.8%,among which the positive rate of hysteromyoma was 66.7%,and the positive rate of ovarian cyst, chocolate cyst, ovarian cystadenoma, mesosalpingitis and endometriosis were 100.0%.The detection rate of malignant tumor was 94.6%,among which the detection rate of cervical cancer, endometrial cancer and ovarian cancer were 97.6%,90.0% and 96.7% respectively.(4) Compared with benign and malignant tumors, SlowADC and StandardADC comparison(P < 0.05),FastADC and FractionADC comparison(P > 0.05) showed similar imaging characteristics.Benign and malignant tumors showed red and blue respectively, which was related to whether the blood supply was rich.Conclusion The DIFFUSION weighted magnetic resonance imaging ADC value has certain value in the differentiation of benign and malignant tumors in female pelvic cavity, and the imaging characteristics are similar, among which SlowADC and StandardADC are more similar, which can provide reference for clinical diagnosis and treatment of diseases.