DCE-MRI与DWI对不同性质囊实性卵巢肿瘤的诊断价值分析
|
摘要
目的分析磁共振动态增强成像(DCE-MRI)与弥散加权成像(DWI)对良性与恶性囊实性卵巢肿瘤的诊断价值。方法收集我院经手术病理证实为囊实性卵巢肿瘤的120例患者临床资料,所有患者术前均进行常规MRI扫描、DCE-MRI及DWI扫描,分析其影像学特征,比较良性与恶性囊实性卵巢肿瘤表观扩散系数(ADC)、容量转运参数(K~(trans))、速率常数(K_(ep))、血管外细胞外间隙容积比(V_e),并评估其诊断效能。结果120例患者中恶性病变67例(55.83%),良性病变53例(44.17%)。囊实性卵巢恶性肿瘤实性部分ADC值显著低于良性肿瘤(P<0.05),囊性部分ADC值与良性肿瘤无显著差异(P>0.05)。当ADC=1.20×10~(-3)mm~2/s时,诊断灵敏度和特异度分别为86.57%、81.13%。囊实性卵巢恶性肿瘤实性部分K_(trans)、K_(ep)及V_e值均显著小于良性肿瘤(P<0.05)。当K~(trans)=0.09min~(-1)时,诊断灵敏度和特异度分别为83.58%、83.02%。DCE-MRI+DWI对良性与恶性囊实性卵巢肿瘤的诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值依次为94.03%、94.34%、94.17%、95.45%、92.59%,均高于单独DCE-MRI检测和单独DWI检测。结论DCE-MRI+DWI对良性与恶性囊实性卵巢肿瘤的诊断效能较好,可作为囊实性卵巢肿瘤术前诊断重要方法。
Objective To analyze the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) and diffusion-weighted imaging(DWI) for benign and malignant cystic ovarian tumors. Methods The clinical data of 120 patients with cystic ovarian tumor confirmed by surgery and pathology in our hospital were collected. All patients were treated with routine MRI scan, DCE-MRI and DWI scan,the imaging features were analyzed, the apparent diffusion coefficient(ADC), volume transport parameter(K~(trans)), rate constant(K_(ep)), extravascular extracellular space volume ratio(V_e) in benign and malignant cystic ovarian tumors were compared, the diagnostic efficacy was evaluated. Results Among the 120 patients, there were 67(55.83%) with malignant lesions and 53(44.17%) with benign lesions. The ADC value of solid part of cystic ovarian malignant tumor was significantly lower than that of benign tumor(P<0.05). There was no significant difference between cystic part ADC and benign tumor(P>0.05). When ADC equaled to 1.20×10~(-3) mm~2/s, the diagnostic sensitivity and specificity were 86.57%and 81.13%, respectively. The K~(trans), K_(ep) and V_e values of solid parts of cystic ovarian malignant tumors were significantly lower than those of benign tumors(P<0.05). When K~(trans) equaled to 0.09 min~(-1), the diagnostic sensitivity and specificity were 83.58% and 83.02%, respectively. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value by DCE-MRI combined with DWI for benign and malignant cystic ovarian tumors were 94.03%, 94.34%, 94.17%, 95.45%, and 92.59%,respectively, all higher than the values by DCE-MRI alone and DWI alone. Conclusion DCE-MRI combined with DWI has a good diagnostic effect on benign and malignant cystic ovarian tumors, it can be used as an important method for preoperative diagnosis of cystic ovarian tumors.
Objective To analyze the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) and diffusion-weighted imaging(DWI) for benign and malignant cystic ovarian tumors. Methods The clinical data of 120 patients with cystic ovarian tumor confirmed by surgery and pathology in our hospital were collected. All patients were treated with routine MRI scan, DCE-MRI and DWI scan,the imaging features were analyzed, the apparent diffusion coefficient(ADC), volume transport parameter(K~(trans)), rate constant(K_(ep)), extravascular extracellular space volume ratio(V_e) in benign and malignant cystic ovarian tumors were compared, the diagnostic efficacy was evaluated. Results Among the 120 patients, there were 67(55.83%) with malignant lesions and 53(44.17%) with benign lesions. The ADC value of solid part of cystic ovarian malignant tumor was significantly lower than that of benign tumor(P<0.05). There was no significant difference between cystic part ADC and benign tumor(P>0.05). When ADC equaled to 1.20×10~(-3) mm~2/s, the diagnostic sensitivity and specificity were 86.57%and 81.13%, respectively. The K~(trans), K_(ep) and V_e values of solid parts of cystic ovarian malignant tumors were significantly lower than those of benign tumors(P<0.05). When K~(trans) equaled to 0.09 min~(-1), the diagnostic sensitivity and specificity were 83.58% and 83.02%, respectively. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value by DCE-MRI combined with DWI for benign and malignant cystic ovarian tumors were 94.03%, 94.34%, 94.17%, 95.45%, and 92.59%,respectively, all higher than the values by DCE-MRI alone and DWI alone. Conclusion DCE-MRI combined with DWI has a good diagnostic effect on benign and malignant cystic ovarian tumors, it can be used as an important method for preoperative diagnosis of cystic ovarian tumors.
引文
[1]牛惠萍,张俊花,薛改琴.超声造影在卵巢肿瘤定性诊断中的应用价值探讨[J].中国药物与临床,2015,15(3):371-372.
[2]Shaha PR,Khetawat R,Sahoo K,et al.Pelvic Mass Lesions in Females:Tissue Characterization Capability of MRI[J].J Clin Diagn Res,2017,11(7):TC01-05.
[3]Nakai G,Yamada T,Yamamoto K,et al.MRI appearance of ovarian serous borderline tumors of the micropapillary type compared to that of typical ovarian serous borderline tumors:radiologicpathologic correlation[J].JOvarian Res,2018,11(1):7.
[4]李新,强金伟,赵书会,等.MR扩散加权成像鉴别卵巢交界性上皮性肿瘤与卵巢癌的b值优化[J].中国医学计算机成像杂志,2 0 1 5,21(6):556-560.
[5]孔鹏,孟令平,杨斌,等.不同b值DWI在卵巢良恶性囊实性病变中的诊断价值[J].实用放射学杂志,2017,33(6):587-590,610.
[6]张朝晖,李竹浩,方字文.不同b值组合时VX2肿瘤ADC值差异的评估及与肌肉的比较[J].广东医学,2017,38(9):1329-1332.
[7]吴斌,黄啸,彭卫军,等.磁共振扩散加权成像在宫颈癌诊断和疗效预测中的价值[J].中华肿瘤杂志,2014,36(2):115-119.
[8]朱志军,郑昌业,刘炳光,等.不同b值对晚孕期胎儿脑弥散加权图像信号强度及信噪比的影响[J].实用医学杂志,2015,31(8):1280-1282.
[9]杨勇,吕秀花,崔光彬,等.超声造影与增强磁共振成像在乳腺良恶性肿瘤鉴别诊断中的应用[J].中国超声医学杂志,2015,31(7):583-586.
[10]申洋,周延,何为,等.基于IVIM模型的扩散加权成像和动态增强核磁共振在卵巢肿瘤良恶性鉴别中的应用价值[J].临床放射学杂志,2016,35(3):410-414.
[11]方如旗,曹代荣,翁淑萍,等.磁共振动态增强及扩散加权成像对复杂性卵巢肿瘤定性诊断的价值[J].临床放射学杂志,2014,33(11):1705-1709.
[12]何业银,李绍东,卢晓冬,等.DWI结合动态增强对卵巢囊实性肿瘤良、恶性的鉴别诊断价值[J].中国CT和MRI杂志,2017,15(4):103-105.
[2]Shaha PR,Khetawat R,Sahoo K,et al.Pelvic Mass Lesions in Females:Tissue Characterization Capability of MRI[J].J Clin Diagn Res,2017,11(7):TC01-05.
[3]Nakai G,Yamada T,Yamamoto K,et al.MRI appearance of ovarian serous borderline tumors of the micropapillary type compared to that of typical ovarian serous borderline tumors:radiologicpathologic correlation[J].JOvarian Res,2018,11(1):7.
[4]李新,强金伟,赵书会,等.MR扩散加权成像鉴别卵巢交界性上皮性肿瘤与卵巢癌的b值优化[J].中国医学计算机成像杂志,2 0 1 5,21(6):556-560.
[5]孔鹏,孟令平,杨斌,等.不同b值DWI在卵巢良恶性囊实性病变中的诊断价值[J].实用放射学杂志,2017,33(6):587-590,610.
[6]张朝晖,李竹浩,方字文.不同b值组合时VX2肿瘤ADC值差异的评估及与肌肉的比较[J].广东医学,2017,38(9):1329-1332.
[7]吴斌,黄啸,彭卫军,等.磁共振扩散加权成像在宫颈癌诊断和疗效预测中的价值[J].中华肿瘤杂志,2014,36(2):115-119.
[8]朱志军,郑昌业,刘炳光,等.不同b值对晚孕期胎儿脑弥散加权图像信号强度及信噪比的影响[J].实用医学杂志,2015,31(8):1280-1282.
[9]杨勇,吕秀花,崔光彬,等.超声造影与增强磁共振成像在乳腺良恶性肿瘤鉴别诊断中的应用[J].中国超声医学杂志,2015,31(7):583-586.
[10]申洋,周延,何为,等.基于IVIM模型的扩散加权成像和动态增强核磁共振在卵巢肿瘤良恶性鉴别中的应用价值[J].临床放射学杂志,2016,35(3):410-414.
[11]方如旗,曹代荣,翁淑萍,等.磁共振动态增强及扩散加权成像对复杂性卵巢肿瘤定性诊断的价值[J].临床放射学杂志,2014,33(11):1705-1709.
[12]何业银,李绍东,卢晓冬,等.DWI结合动态增强对卵巢囊实性肿瘤良、恶性的鉴别诊断价值[J].中国CT和MRI杂志,2017,15(4):103-105.