基于IVIM的MR扩散加权成像(DWI)对卵巢癌分型的诊断价值

目的探讨基于体素内不相干运动(IVIM)的磁共振扩散加权成像(MR-DWI)对卵巢上皮癌分型的诊断价值。方法将201 6年1月至201 8年7月我院收治的经手术病理检查确诊为卵巢上皮癌的5 4例患者作为研究对象,所有患者术前均进行过MR-DWI检查,根据二元分型理论将患者分为Ⅰ型(低级别)和Ⅱ型(高级别),通过单、双指数模型获得其表观扩散系数(ADC)、单纯水分子扩散系数(D)、灌注相关扩散系数(D*)和灌注分数(f),比较两种分型差异,并绘制ROC曲线,探讨各参数对卵巢上皮癌分型的诊断价值。结果病理检查结果显示,Ⅰ型卵巢上皮癌患者23例,Ⅱ型卵巢上皮癌患者31例。Ⅱ型患者ADC、D、f值均低于Ⅰ型(P<0.05),D~*值与Ⅰ型无显著差异(P> 0.05)。以病理结果为标准,ADC、D、f值的ROC曲线下面积分别为0.885、0.8 92、0.740,ADC值=1.172×10~3mm^2/S、D值=0.8 19×10~3mm^2/s、f值=27.6 8%时,其对应约登指数最大。ADC值对卵巢上皮癌分型诊断灵敏度和特异度为87.10%和82.61%;D值对卵巢上皮癌分型诊断灵敏度和特异度为93.55%和86.96%;f值对卵巢上皮癌分型诊断灵敏度和特异度为74.19%和73.91%。结论IVIM参数D值对卵巢上皮癌分型诊断效能较好。

Diagnostic Value of IVIM-based MR Diffusion-weighted Imaging(DWI)for Ovarian Cancer Typing

Objective To investigate the diagnostic value of magnetic resonance diffusionweighted imaging(MR-DWI) in the typing of ovarian epithelial cancer based on incoherent motion in voxel(IVIM).Methods 54 patients with ovarian epithelial cancer diagnosed by surgical pathology examination from January 2016 to July 2018 in the hospital were selected in the study.All patients underwent MR-DWI before surgery.According to binary typing theory,the patients were divided into type Ⅰ(low level) and type Ⅱ(high level),their apparent diffusion coefficient(ADC),simple water molecule diffusion coefficient(D),perfusion-related diffusion coefficient(D*) and perfusion score(f)were obtained by single,double exponential model,the differences of the two typing were compared,ROC curve was drawn,the diagnostic value of each parameter for ovarian epithelial cancer typing was explored.Results Pathological examination results showed that there were 23 patients with type Ⅰ ovarian epithelial cancer and 31 patients with typeⅡ ovarian epithelial cancer.The values of ADC,D,and f of type Ⅱ patients were lower than those of type Ⅰ(P<0.05),there was no significant difference between D*and type Ⅰ(P>0.05).Taking the pathological results as the standard,the areas under the ROC curve of ADC,D,and f values were 0.885,0.892,and 0.740,respectively.The ADC value equaled 1.172×10-3mm2/s,D value equaled 0.819×10-3mm2/s,f value equaled 27.68%,its corresponding yueden’s index was the largest.The sensitivity and specificity with ADC value for the diagnosis of ovarian epithelial cancer typing were 87.10% and 82.61%.The sensitivity and specificity with D value for the diagnosis of ovarian epithelial cancer typing were 93.55% and 86.96%.The sensitivity and specificity with f value for the diagnosis of ovarian epithelial cancer typing were 74.19% and 73.91%.Conclusion The D value of IVIM parameter has good diagnostic efficiency for the typing of ovarian epithelial cancer.