卵巢囊实性恶性肿瘤弥散加权成像的临床应用价值

目的探讨磁共振弥散加权成像对卵巢囊实性恶性肿瘤的诊断价值。方法对12例卵巢囊实性恶性肿瘤和13例正常卵巢进行常规MRI扫描和横断面DWI(b=600s/mm2),分别比较卵巢囊实性恶性肿瘤与正常卵巢的实性部分及囊性部分的表观弥散系数(apparent diffusion coefficient,ADC)值和指数表观弥散系数(exponent apparent diffusion,EADC)值,并进行统计学分析。结果卵巢囊实性恶性肿瘤实性部分DWI呈明显高信号,其ADC值(1.50±0.41)×10-3mm2/s]显著低于正常卵巢实性部分的ADC值(2.24±0.33)×10-3mm2/s](P0.01),前者eADC值(254.33±97.23)×10-3mm2/s]显著高于后者eADC值(121.15±30.69)×10-3mm2/s];卵巢囊实性恶性肿瘤囊性部分DWI表现为稍高、等、稍低信号,其ADC值(4.18±2.98)×10-3mm2/s]及eADC值(58.95±33.45)×10-3mm2/s]与正常卵巢囊性部分的ADC值(2.92±1.42)×10-3mm2/s]及eADC值(119.18±140.54)×10-3mm2/s]没有明显差别。结论DWI的定量分析对卵巢囊实性恶性肿瘤的早期诊断具有重要的诊断及鉴别诊断意义。

Clinical value of Diffusion Weighted Imaging in Cystic-solid Ovarian Carcinoma

Objective To investigate the role of diffusion weighted imaging（DWI） in the diagnosis of cystic-solid ovarian carcinoma.Methods Routine MRI sequence and axial diffusion weighted sequence（b=600 s/mm2）were performed in 12 patients with cystic-solid ovarian carcinoma and in 13 healthy women.Apparent diffusion coefficient（ADC）value and exponent apparent diffusion coefficient（eADC）value of cystic components and solid components in normal ovary and ovarian carcinoma were relatively compared.Results The solid component showed high signal intensity on DWI map.The ADC value of solid component was significantly lower in cystic-solid ovarian carcinoma than in normal ovary （1.50 ± 0.41）× 10-3 mm2/s vs（.2.24 ± 0.33） ×10-3 mm2/s],and the eADC value was significantly higher in cystic-solid ovarian carcinoma than in normal ovary（254.33 ± 97.23）× 10-3 mm2/s vs.（121.15 ±30.69）× 10-3mm2/s].The cystic component showed intermediate signal intensity on DWI map.The ADC value and eADC value of cystic component was no significant difference in normal ovary and cystic-solid ovarian carcinoma（4.18 ± 2.98）× 10-3 mm2/s vs（.2.92 ± 1.42）× 10-3 mm2/s and（58.95 ± 33.45）× 10-3 mm2/s vs.（119.18 ±140.54）×10-3 mm2/s].Conclusion The quantitative analysis of DWI could be useful in diagnosis and differential diagnosis of cystic-solid ovarian carcinoma.