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1. 复旦大学附属金山医院影像科,上海,201508
2. 江苏省南通市肿瘤医院放射科,江苏,南通,226361
3. 复旦大学附属妇产科医院放射科,上海,200011
4. 上海交通大学医学院附属新华医院放射科,上海,200092
网络出版:2016-05-04,
纸质出版:2016-05-04
移动端阅览
李海明, 强金伟, 马风华, 等. 动态增强MRI在卵巢良恶性肿瘤鉴别中的价值[J]. 肿瘤影像学, 2016,25(1):66-70.
李海明,强金伟,马风华,等. 动态增强MRI在卵巢良恶性肿瘤鉴别中的价值[J]. 肿瘤影像学, 2016, 25(1): 66-70
目的:
探讨动态增强MRI(dynamic contrast-enhanced MRI,DCE-MRI)对卵巢良恶性肿瘤的诊断和鉴别诊断价值。
方法:
回顾性分析经手术和病理证实、含有实质成分的86例卵巢良恶性肿瘤(良性15个、恶性71个)的DCE-MRI资料。评价标准包括时间-强度曲线(time-intensity curve,TIC)类型(分为Ⅰ、Ⅱ、Ⅲ型)和3项半定量参数:增强幅度(enhancement amplitude,EA)、最大斜率(maximal slope,MS)及达峰值一半时间(time of half rising,THR),比较良恶性肿瘤的差异。
结果:
恶性肿瘤中,TIC Ⅲ型59例(83%)、Ⅱ型12例(17%),未见Ⅰ型;良性肿瘤中,TIC Ⅰ型5例(33%)、Ⅱ型10例(67%),未见Ⅲ型;TIC类型在良恶性肿瘤中差异有统计学意义(
P
<0.001)。恶性肿瘤的平均EA及MS值均大于良性肿瘤[(267.486.2)
vs
.(220.290.5),(11.06.3)
vs
.(6.14.7),
P
值分别为0.05和<0.001
]
,而THR值则低于良性肿瘤[(32.87.6)s
vs
. (55.515.4)s,
P
<0.001)
]
。THR值是诊断效能最高的指标,受试者工作特性曲线的曲线下面积为89%。当THR<45 s时,诊断灵敏度、特异度、准确率、阳性和阴性预测值分别为94%、80%、92%、96%和75%。
结论:
DCE-MRI的TIC类型及其3个半定量参数有助于卵巢良恶性肿瘤的鉴别。
Objective:
To investigate the value of dynamic contrast-enhanced MRI (DCE-MRI) in the differential diagnosis of ovarian malignant and benign tumors.
Methods:
DCE-MRI data of 86 ovarian tumors with solid compositions (benign 15
malignant 71) confirmed by surgery and pathology were retrospectively analyzed. The patterns (Ⅰ
Ⅱ and Ⅲ) of time-intensity curve
(TIC) and three semi-quantitative parameters including enhancement amplitude (EA)
maximal slope (MS) and time of half rising (THR) were evaluated and compared between ovarian benign and malignant tumors.
Results:
Among malignant ovarian tumors
59 (83%) were type Ⅲ
12 (17%) were type Ⅱ
and no type Ⅰ. Among benign ovarian tumors
5 (33%) were typeⅠ
10 (67%) were type II
and no type Ⅲ. There was significant difference in TIC pattern between benign and malignant tumors (
P
0.001). The mean values of EA and MS in malignant ovarian tumors were significantly higher than those in benign tumors [(267.486.2)
vs
. (220.290.5)
(11.06.3)
vs
. (6.14.7);
P
=0.05 and
P
0.001
respectively
]
. Whereas the mean value of THR in malignant tumors was significantly lower than that in benign tumors [(32.87.6) s
vs
. (55.515.4) s;
P
0.001
]
. THR was the best diagnostic indicator among three semiquantitative parameters
and the area under the receiver operating characteristic (ROC) curve was 89%. When the cutoff value of THR was 45 s
the sensitivity
specificity
accuracy
positive and negative predictive values were 94%
80%
92%
96% and 75%
respectively.
Conclusion:
TIC patterns and semi-quantitative parameters of DCE-MRI are helpful in distinguishing malignant from benign ovarian tumors.
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