摘要
目的：探讨MR扩散加权像（DWI）结合ADC值定量分析在卵巢囊实性肿瘤中的诊断价值，并寻求良恶性病变的ADC值最佳阈值。材料和方法：对84例卵巢肿瘤的大体形态、结构特点，MRI信号特征、增强方式，尤其是DWI信号特征及ADC值进行回顾性分析，并做ROC曲线以确定最佳阈值。结果：良、恶性卵巢肿瘤的实质部分的ADC均值分别为（1.456±0.297）×10-3 mm2/s、（0.929±0.215）×10-3 mm2/s，两者之间有明显统计学差异（P＜0.01）。ROC曲线结果显示，ADC值≥1.225×10-3 mm2/s可作为良恶性卵巢肿瘤鉴别的最佳阈值，其鉴别良、恶性的敏感度、特异度及曲线下面积分别为86.7%、94%和92.1%。结论：DWI作为常规MRI的有益补充，尤其是ADC值的量化，有助于卵巢肿瘤良恶性的鉴别诊断。
Abstract
Objective: To retrospectively estimate the diagnostic accuracy of diffusion-weighted MR imaging(DWI) in complex solid and cystic adnexal masses, and to determinate the optimal cutoff value for differentiating benign and malignant ovarian tumors. Materials and Methods: Eighty-four patients underwent DWI. The adnexal lesions were examined for several features including size, shape, character(solid-cystic), signal intensity, and enhancement. The mean ADC value of the solid components was measured and assessed for each ovarian mass. Receiver operating characteristic(ROC) was used to assess ability of ADC in differentiating benign versus malignant complex adnexal masses. Results: The mean ADC value was (1.456±0.297)×10-3 mm2/s and (0.929±0.215)×10-3 mm2/s for the benign and malignant masses respectively, and there was significant difference between them(P﹤0.01). The ROC results suggested that an ADC value ≥1.225×10-3 mm2/s might be an optimal cutoff value for differentiating benign and malignant tumors, with sensitivity of 86.7%, specificity of 94% and AUC of 92.1%，respectively. Conclusion: DWI is a useful supplement to conventional MRI. The measurement of ADC values of the solid components is especially useful for differentiating benign from malignant ovarian masses.
关键词
卵巢肿瘤 /
磁共振成像
Key words
Ovarian neoplasms /
Magnetic resonance imaging
崔艳芬;李文华;祝明洁;汪登斌;张 萍;张忠阳;储彩婷.
扩散加权成像在复杂性卵巢肿瘤的临床应用研究[J]. 中国临床医学影像杂志. 2012, 23(12): 856-859
CUI Yan-fen;LI Wen-hua;ZHU Ming-jie;WANG Deng-bin;ZHANG Ping;ZHANG Zhong-yang;CHU Cai-ting.
Clinical application and research of diffusion weighted MR imaging in complex ovarian tumors[J]. Journal of China Clinic Medical Imaging. 2012, 23(12): 856-859
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