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目的探索扩散加权成像(DWI)体素内不相干运动模型(IVIM)参数在卵巢肿瘤良恶性鉴别中的价值,以及IVIM-DWI与动态增强核磁共振(DCE-MRI)的相关性。方法采用诊断性研究方法,搜集卵巢占位性病变且经手术、病理证实的患者共65例,其中良性肿瘤31例,恶性肿瘤34例。应用3.0 T核磁共振仪和8通道心脏相控阵线圈对患者进行盆腔MRI扫描。寻找最具有良恶性卵巢肿瘤鉴别价值的IVIM参数,计算各参数的诊断界值,敏感性与特异性,应用Pearson相关性分析检验IVIM的灌注参数与DCE-MRI定量参数间的相关性。结果表观扩散系数(ADC)、慢扩散系数(Dslow)、f*Dfast、速率常数(K_ep)、Ve值在卵巢良性与恶性肿瘤之间具有统计学差异,其中ADC、Ve值敏感度较高但特异性偏低,f*Dfast、容积转运常数(K~(trans))和K_ep值特异性高但敏感度极低,Dslow、Dfast和f值的特异性和敏感度都为中等。Dfast与K_ep、f与K_ep之间存在相关关系,但仅为弱相关(r=0.225,r=-0.317)。结论该研究所测试IVIM-DWI系数与DCE-MRI部分定量参数在卵巢良恶性肿瘤鉴别中有应用价值,其中ADC和Ve值敏感度较高,而f*Dfast和K_ep值特异性较高,可以在临床诊断中作为参考指标。
Objective To explore the value of diffusion-weighted imaging (DWI) in vivo non-coherence motion model (IVIM) parameters in differential diagnosis of benign and malignant ovarian tumors and the correlation between IVIM-DWI and dynamic enhanced nuclear magnetic resonance (DCE-MRI). Methods A total of 65 patients with pathologically confirmed ovarian space-occupying lesions were enrolled in this study, including 31 benign tumors and 34 malignant tumors. Pelvic MRI scans were performed on patients using the 3.0 T NMR and 8-channel cardiac phased-array coils. To find out the IVIM parameters which have the best value in differentiating benign and malignant ovarian tumors, calculate the diagnostic limit, sensitivity and specificity of each parameter. Pearson correlation analysis was used to test the correlation between IVIM perfusion parameters and DCE-MRI quantitative parameters. Results The apparent diffusion coefficient (ADC), slow diffusion coefficient (Dslow), f * Dfast, rate constant (K_ep) and Ve value were significantly different between benign and malignant ovarian tumors, and ADC and Ve values were higher But low specificity, f * Dfast, volumetric transport constants (K ~ (trans)) and K_ep values were highly specific but sensitive, and the specificity and sensitivity of Dslow, Dfast and f values were moderate. There was a correlation between Dfast and K_ep, f and K_ep, but only weakly (r = 0.225, r = -0.317). Conclusion The quantitative parameters of IVIM-DWI and DCE-MRI in this study are of great value in the differential diagnosis of benign and malignant ovarian tumors. Among them, the sensitivity of ADC and Ve is high, but the specificity of f * Dfast and K_ep is high, In clinical diagnosis as a reference index.