CT、动态增强磁共振成像及弥散加权成像对卵巢囊腺癌与囊腺瘤的鉴别诊断价值

Differential diagnostic value of CT, dynamic contrast-enhanced magnetic resonance imaging, and diffusion-weighted imaging for ovarian cystadenocarcinoma and cystadenoma

目的研究CT、动态增强磁共振成像(DCE-MRI)以及弥散加权成像(DWI)对卵巢囊腺癌和囊腺瘤的鉴别诊断价值。方法回顾性抽取2014年1月至2023年11月延安市人民医院收治的卵巢囊腺癌和囊腺瘤患者共68例进行研究, 根据病理检查情况将患者分为囊腺癌组(36例)和囊腺瘤组(32例)。收集两组患者CT、DCE-MRI和DWI检查资料并进行对比分析, 观察CT、DCE-MRI和DWI对卵巢囊腺癌和囊腺瘤的鉴别诊断价值。结果囊腺癌患者扫描CT值高于囊腺瘤患者, 且两组患者在囊性/囊实性、边缘、单房/多房、形态以及密度上等CT特征上比较差异均有统计学意义(P均<0.05)。囊腺癌患者容量转移常数(Ktrans)大于囊腺瘤患者, 表观扩散系数(ADC)、噪声比(CNR)低于囊腺瘤患者(P<0.05)。联合诊断的曲线下面积(AUC)高于CT值、Ktrans、ADC以及CNR单独诊断的AUC, 差异有统计学意义(P<0.05)。结论 CT、DCE-MRI以及DWI对卵巢囊腺癌和卵巢囊腺瘤均具有鉴别诊断价值, CT值、Ktrans、ADC以及CNR联合诊断价值更高。

Objective To study the value of CT,dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI),and diffusion-weighted imaging(DWI)in differential diagnosis of ovarian cystadenocarcinoma and cystadenoma.Methods A total of 68 patients with ovarian cystadenocarcinoma or cystadenoma admitted to Yan’an People’s Hospital from January 2014 to November 2023 were retrospectively selected.According to the pathological examination results,the patients were divided into the cystadenocarcinoma group(36 cases)and the cystadenoma group(32 cases).The CT,DCE-MRI,and DWI examination data of two groups were collected and compared.The value of CT,DCE-MRI,and DWI in differential diagnosis of ovarian cystadenocarcinoma and cystadenoma were observed.Results The CT values of patients with cystadenocarcinoma were higher than those of patients with cystadenoma,and there were statistically significant differences between the two groups in CT features such as cystic/cystic-solid,margin,single/multi chamber,morphology,and density(all P<0.05).Transfer constant(Ktrans)in patients with cystadenocarcinoma was higher than that in patients with cystadenoma,while apparent diffusion coefficient(ADC)and contrast-to-noise ratio(CNR)were lower than those in patients with cystadenoma,and the differences were statistically significant(P<0.05).The area under the curve of combined diagnosis was higher than that of CT value,Ktrans,ADC,and CNR alone diagnosis(P<0.05).Conclusions CT,DCE-MRI,and DWI all have differential diagnostic value for ovarian cystadenocarcinoma and ovarian cystadenoma.The diagnostic value of combination of CT value,Ktrans,ADC and CNR is higher.