增强T2*加权血管成像定量参数在预测卵巢囊腺肿瘤侵袭性中的应用价值

Application of Enhanced T2*Weighted Angiography Quantitative Parameters in Predicting the Invasiveness of Cystic Gland Tumors

目的 分析增强T2*加权血管成像(ESWAN)定量参数在预测卵巢囊腺肿瘤侵袭性中的应用价值。资料与方法 回顾性选取2018年6月—2023年6月宣城市中心医院经病理检查证实的81例卵巢囊腺瘤,所有患者均行盆腔MRI检查(含ESWAN序列),ESWAN数据经处理后获得幅度值、相位值、R2*值及T2*值,并使用AnatomySketch软件自动获得定量肿瘤内部磁敏感信号比。根据卵巢囊腺肿瘤的侵袭性分为恶性囊腺肿瘤组和良性囊腺肿瘤(包括良性和交界性囊腺瘤)组,比较两组各参数的差异,并采用受试者工作曲线评价各参数对卵巢囊腺肿瘤的侵袭性的预测效能。结果 81例卵巢囊腺肿瘤中,恶性囊腺肿瘤29例,发生率为35.80%;恶性囊腺肿瘤组的糖类抗原125、R2*值、肿瘤内部磁敏感信号比均高于良性囊腺肿瘤组,差异有统计学意义(t=15.153、14.006、8.200,P<0.05);R2*值(OR=3.464,95%CI 1.712~7.008,P=0.001)、肿瘤内部磁敏感信号比(OR=8.376,95%CI 1.399~14.519,P=0.002)是恶性卵巢囊腺肿瘤发生的独立危险因素(OR>1,P<0.05);R2*值、肿瘤内部磁敏感信号比和两者联合预测恶性卵巢囊腺肿瘤的最佳临界值分别为5.700、0.165、0.557,曲线下面积分别为0.942、0.870、0.975;敏感度分别为82.80%、82.80%、89.70%,特异度分别为96.20%、75.00%、98.10%。结论 R2*值、肿瘤内部磁敏感信号比是恶性囊腺肿瘤的独立预测分子,两者联合能提升对卵巢囊腺肿瘤侵袭性的预测效能。

Purpose To analyze the applicationvalue of enhanced T2*weighted angiography(ESWAN)quantitative parameters in predicting the invasiveness of cystic gland tumors.Materials and Methods A total of 81 patients with ovarian cystadenoma confirmed by pathological examination in Central Hospital of Xuancheng City,Anhui Province from June 2018 to June 2023 were retrospective selected.All patients underwent pelvic MRI examination(including ESWAN sequence).The ESWAN data was processed to obtain amplitude,phase,R2*and T2*values,and the quantitative intratumoral susceptibility signal(ITSS)ratio was automatically obtained using AnatomySketch software.According to the invasiveness of ovarian cystic gland tumors,they were divided into malignant cystic gland tumor group and benign cystic gland tumor group(including benign and borderline cystic gland tumors).The differences in various parameters between the two groups were compared,and the receiver operating curve was used to evaluate the predictive efficacy of each parameter on the invasiveness of ovarian cystic gland tumors.Results Among the 81 patients with ovarian cystic tumors,29 patients were in the malignant cystic tumor group,with an incidence rate of 35.80%.The CA-125,R2*values and ITSS ratio in the malignant cystic gland tumor group were higher than those in the benign cystic gland tumor group,and the differences were statistically significant(t=15.153,14.006,8.200,all P<0.05).The R2*value(OR=3.464,95%CI 1.712-7.008,P=0.001)and ITSS ratio(OR=8.376,95%CI 1.399-14.519,P=0.002)were independent risk factors for the occurrence of malignant ovarian cystadenoma(OR>1,P<0.05);the optimal critical values for R2*value,ITSS ratio and their combined prediction of malignant ovarian cystic tumors were 5.700,0.165 and 0.557,respectively.The area under the curve was 0.942,0.870 and 0.975,respectively.The sensitivity was 82.80%,82.80%and 89.70%,and the specificity was 96.20%,75.00%and 98.10%.Conclusion R2*value and ITSS ratio are independent predictive molecules for malignant cystic tumors,and their combination can enhance the predictive efficacy of invasiveness in ovarian cystic tumors.