DCE-MRI联合ADC及CA125、HE4对卵巢上皮性肿瘤良恶性鉴别的价值

The Application Value of DCE-MRI Combined with ADC,CA125,HE4 in Differentiating Benign and Malignant Ovarian Epithelial Tumors

目的通过研究动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)、表观扩散系数(apparent diffusion coefficient,ADC)、血清糖类抗原125(CA125)、人附睾分泌蛋白(HE4)及其联合应用对卵巢上皮性肿瘤良恶性的鉴别诊断效能,探讨运用于卵巢上皮性肿瘤诊断的最佳方法。方法回顾性分析我院2022年1月至2022年12月收治的76例卵巢上皮性肿瘤患者为研究对象,病理证实良性36例,恶性40例。分别记录良、恶性肿瘤患者的DCE-MRI定量参数K^(trans),DWI扫描自动生成的ADC图上勾画ROI(感兴趣区)获得ADC值,并通过LIS系统调取其CA125及HE4指标并进行统计,同时以病理诊断结果为金标准,计算不同检查方法及联合应用对诊断卵巢上皮性肿瘤良恶性诊断的灵敏度、特异度。结果K^(trans)、ADC、CA125及HE4指标对卵巢上皮性肿瘤良恶性诊断的灵敏度分别为92.5%、80.0%、72.5%,特异度分别为86.1%、75.0%、88.8%;恶性组患者CA125及HE4水平明显高于良性组;联合应用对良性、恶性卵巢上皮性肿瘤诊断的敏感性及特异性高于单一检查,具有统计学差异(P<0.05)。结论DCE-MRI联合ADC及CA125、HE4对卵巢上皮性肿瘤良恶性鉴别诊断的效能优于单一检查,可提高术前对卵巢上皮性肿瘤良恶性鉴别诊断的价值。

Objective To investigate the differential diagnostic efficacy of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI),apparent diffusion coefficient(ADC),serum carbohydrate antigen 125(CA125),human epididymal secreted protein(HE4),and their combined applications in benign and malignant ovarian epithelial tumors,and to explore the best method for the diagnosis of ovarian epithelial tumors.Methods A retrospective analysis was conducted on 76 patients with ovarian epithelial tumors admitted to our hospital from January 2022 to December 2022,with 36 cases confirmed to be benign and 40 cases confirmed to be malignant by pathology.Record the quantitative parameters K^(trans) of DCE-MRI in patients with benign and malignant tumors,and draw ROI(area of interest)on the ADC map automatically generated by DWI scanning to obtain ADC values,and retrieve its CA125 and HE4 indicators through the LIS system and perform statistics,at the same time,pathological diagnosis results are used as the gold standard,Calculate the sensitivity and specificity of different examination methods and their combined applications in diagnosing benign and malignant ovarian epithelial tumors.Results The diagnostic sensitivity of K^(trans),ADC,CA125,and HE4 indicators for benign and malignant ovarian epithelial tumors was 92.5%,80.0%and 72.5%respectively,with specificity of 86.1%,75.0%and 88.8%;The levels of CA125 and HE4 in the malignant group were significantly higher than those in the benign group;The sensitivity and specificity of combined application for benign and malignant ovarian epithelial tumors were higher than those of single examination,with statistical differences(P<0.05).Conclusion The efficacy of DCE-MRI combined with ADC,CA125,and HE4 in the differential diagnosis of benign and malignant ovarian epithelial tumors is superior to that of a single examination,which can improve the value of preoperative differential diagnosis of benign and malignant ovarian epithelial tumors.