MRI图像特征结合ADC值在鉴别卵巢交界性囊腺瘤与囊腺癌中的应用

目的探讨磁共振(MRI)图像特征结合表观弥散系数(ADC)值在鉴别卵巢交界性囊腺瘤与囊腺癌中的应用价值。方法回顾分析本院经术后病理确诊的18例卵巢交界性囊腺瘤(A组)和24例卵巢囊腺癌(B组)患者的MRI图像资料。所有患者均行MRI平扫、增强和弥散加权成像(DWI)扫描。观察肿瘤部位、大小、形态、分房、囊壁、囊隔及信号特征,并测量肿瘤实性部分的ADC值,比较两组间的差异。使用受试者工作特征(ROC)曲线分析ADC值在两组间的最佳阈值及对应的敏感性和特异性。结果两组病灶分布侧别、大小、单/多房比例无统计学差异(P均>0.05)。A组病灶囊性部分囊壁/囊隔厚度(最厚处)小于B组,实性部分明显强化的比例低于B组,实性部分ADC值高于B组(P均<0.05)。ROC曲线分析示ADC值鉴别两组病灶的最佳阈值是1.315×10^-3mm^2/s,对应的敏感性和特异性分别为84.2%和81.5%。结论结合MR图像特征和量化的ADC值有利于正确区分卵巢交界性囊腺瘤与囊腺癌,为临床选择合适的治疗方案奠定基础。

The Application of MRI Image Features Combined with ADC Value in Differentiating Ovarian Borderline Cystadenoma from Cystadenocarcinoma

Objective To explore the application value of magnetic resonance imaging(MRI)image features combined with apparent diffusion coefficient(ADC)in the differentiation of ovarian borderline cystadenoma and cystadenocarcinoma.Methods MRI images of 18 cases of ovarian borderline cystadenoma(Group A)and 24 cases of ovarian cystadenocarcinoma(Group B)were analyzed retrospectively.All patients underwent MRI plain scan,enhancement and diffusion weighted imaging(DWI)scanning.The location,size,shape,cell division,wall,septum and signal characteristics were observed and apparent diffusion coefficient(ADC)values of tumorous solid portion were measured and compared between the two groups.The optimal threshold of the ADC value between the two groups and corresponding sensitivity and specificity were analyzed using the receiver operating characteristic(ROC)curve.Results There were no statistically significant differences in the distribution of lesions,size,and ratio of single/multiple cells between the two groups(all P>0.05).The lesion wall/septum thickness(the thickest part)of cystic part in group A was less than that in group B,the proportion of significantly enhanced of solid part was lower than that in group B,and the ADC value of solid part was higher than that in group B(all P<0.05).ROC curve analysis showed the optimal ADC value was 1.315×10^-3mm^2/s for identifying lesions of two groups,corresponding sensitivity and specificity were 84.2%and 81.5%.Conclusion The combination of MRI image features and quantified ADC values is conducive to the correct differentiation of ovarian borderline cystadenoma and cystadenocarcinoma,laying a foundation for the clinical selection of appropriate treatment options.