| 盆腔MRI平扫、钆喷酸葡胺增强扫描及扩散加权成像对盆腔脓肿患者的诊断价值:64例患者前瞻性研究 |
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| 作者姓名： | 贾瑞娟 杨侃荣 赵继泉 董巨浪 帅建刚 魏君 |
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| 作者单位： | 佛山市第二人民医院，广东 佛山 528000 |
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| 摘 要： | 目的探讨盆腔MRI平扫、钆喷酸葡胺增强扫描及扩散加权成像（DWI）对盆腔脓肿患者的诊断效能。方法选择2018年1月~2019年6月收治的64例拟诊为盆腔脓肿的患者作为研究对象，全部患者均经MRI平扫、增强扫描及DWI检查。以活检或手术病理作为金标准，评估MRI平扫、增强扫描及DWI检查诊断盆腔脓肿的结果，并比较各检查方法的效能指标（灵敏度、特异度、准确率、阳性预测值、阴性预测值），绘制ROC曲线比较各检查方法诊断曲线下面积，观察盆腔脓肿的MRI表现。结果增强扫描、DWI敏感度、特异度和准确率与MRI平扫对比差异均无统计学意义（P > 0.05）；增强扫描与DWI敏感度、特异度和准确率对比差异均无统计学意义（P > 0.05）。DWI和增强扫描ROC曲线下面积高于MRI平扫（P < 0.05），增强扫描与DWI的曲线下面积对比差异无统计学意义（P > 0.05）。MRI平扫准确诊断39例，多数为囊实性包块、形态不规则、边界清晰、可见包膜、有明显分隔；T1WI序列显示包块总体呈低信号，T2WI序列显示包块呈不均匀的高信号和稍高信号。DWI检查显示多数病灶呈高信号，低ADC值，扩散明显受限。增强扫描显示多数病灶表现为渐进性强化，部分病灶分隔壁出现不同程度的强化。结论盆腔MRI、钆喷酸葡胺增强扫描及DWI诊断盆腔脓肿均效能良好，其中增强扫描效能最高。
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| 关 键 词： | 盆腔脓肿 MRI 磁共振增强扫描 扩散加权成像 诊断 |
| 收稿时间： | 2020-04-07 |
Diagnostic value of pelvic magnetic resonance plain scan,GD-DTPA enhanced scan and DWI on patients with pelvic abscess: a prospective study of sixty-four patients |
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| Authors: | Ruijuan JIA Kanrong YANG Jiquan ZHAO Julang DONG Jiangang SHUAI Jun WEI |
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| Affiliation: | Foshan Second People's Hospital, Foshan 528000, China |
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| Abstract: | ObjectiveTo explore the diagnostic efficacy of pelvic MRI plain scan, gadopentetate dimeglumine enhanced scan and diffusion-weighted imaging (DWI) on patients with pelvic abscess.MethodsSixty-four patients with possible pelvic abscess who were admitted from January 2018 to June 2019 were selected. All patients underwent MRI plain scan, enhanced scan and DWI. The biopsy or surgical pathology was used as the gold standard, and the results of MRI plain scan, enhanced scan and DWI examination were evaluated in the diagnosis of pelvic abscess. The efficacy indicators (sensitivity, specificity, accuracy rate, positive predictive value, negative predictive value) of each examination method were compared. ROC curve was drawn to compare the AUC of each examination method, and the MRI findings of pelvic abscess were observed.ResultsThe differences in the sensitivity, specificity and accuracy rate between enhanced scan and DWI compared with those of MRI plain scan were not significant (P > 0.05). The differences in the sensitivity, specificity and accuracy rate between enhanced scan and DWI were not significant (P > 0.05). The AUC value of ROC of DWI and enhanced scan was higher than that of MRI plain scan (P < 0.05). The difference of the AUC between enhanced scan and DWI was not significant (P > 0.05). MRI plain scan accurately diagnosed 39 cases, most of which were cystic solid masses, with irregular shape, clear boundary, visible capsule and obvious separation. T1WI sequence showed that the masses were mostly with low signal, and T2WI sequence showed the masses were with uneven high signal and slightly higher signal. DWI examination showed that most lesions were with high signal, low ADC value and obviously limited diffusion. Enhanced scan showed that most lesions showed progressive enhancement and some lesions showed different degrees of enhancement on the dividing wall.ConclusionPelvic MRI, gadopentetate dimeglumine enhanced scan and DWI all have good efficacy in the diagnosis of pelvic abscess. The enhanced scan has the highest efficacy. |
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