MRI结合血清CA125对卵巢肿块的定性诊断

目的探讨MRI常规扫描、DWI及血清CA125对卵巢肿块的定性诊断价值。方法收集76例卵巢肿块患者MRI及临床资料。使用西门子1.5T超导磁共振机,行常规矢状位T2WI、横轴位T1WI及抑脂T2WI,DWI取b值为50、500、800s/mm2。在西门子后处理工作站分析卵巢肿块的信号特征,测量良、恶性肿瘤实性部分的ADC值。结果卵巢良性(非畸胎瘤)、恶性肿瘤实性部分的ADC值差异有统计学意义(P0.05);ROC曲线下面积0.904,最佳诊断阈值为1.281×10-3mm2/s。MRI诊断卵巢良、恶性肿块的敏感度为80.0%,特异度为92.2%,约登指数为72.2%,Kappa值为0.729;MRI结合血清CA125诊断卵巢良、恶性肿块的敏感度为88.0%,特异度为94.1%,约登指数为82.1%,Kappa值为0.821。结论 MRI多序列扫描结合ADC值定量分析、并参照血清CA125对卵巢肿块的定性诊断有重要价值,能有效提高鉴别诊断水平。

The Qualitative Diagnosis of MRI Combined with Serum CA125 in Ovarian Tumors

Objective To investigate the value of MRI, DWI and serum CA125 in qualitative diagnosis of ovarian tumors.Methods Collected MRI and clinical data of 76 patients with ovarian tumors.All cases underwent MR imaging including sagittal T2WI, axial T1WI and T2WI with fat satturation, DWI sequence(b=50,500, 800s/mm2) at 1.5 T Siemens MR scanner. In Siemens post-processing workstation analysis of signal characteristics of ovarian tumors, benign and malignant solid tumor measurement part of the ADC values.Results There was a significant difference(P<0.05) between the ADC value comparison about solid parts of ovarian benign (not teratoma)and malignant tumor, the area under the ROC curve for 0.904, the best diagnostic threshold for 1.281×10-3 mm2/s.In The MRI diagnosis ,the sensitivity, specificity,Youden index and the Kappa value were 80.0%, 92.2%, 72.2% and 0.729, in the MRI combined with serum CA125 diagnosis, the sensitivity, specificity. Youden index and the Kappa value were 88.0%, 94.1%, 82.1% and 0.821.Conclusion The conventional MRI combined with ADC values, and serum CA125 in qualitative diagnosis of ovarian tumor has an important value, can effectively improve the level of differential diagnosis.