目的 探讨DWI技术结合动态增 强扫描对卵巢囊实性肿瘤良、恶性的 鉴别诊断价值。方法 回顾性分析经手 术病理证实的39例囊腺瘤(良性组)与36 例囊腺癌(恶性组)患者的MR常规平扫、 DWI及动态增强图像，测量良、恶性组实 性成分的平均ADC值，并进行统计学分 析。结果 良性组实性成分平均ADC值为 (1.62±0.24)×10-3mm2 /s，恶性组实性 成分平均ADC值为（0.92±0.15）×10-3 mm2 /s，良性组与恶性组实性成分ADC值 之间差异有统计学意义(t=-14.999,p ＜0.001)，DWI结合MR平扫+增强扫描对 卵巢囊实性肿瘤良、恶性鉴别的正确指 数、灵敏度、特异度、阳性预测值、阴性 预测值分别为0.842、94.44%、89.74%、 89.47%、94.59%，当选取阈值ADC值为 1.26×10-3mm2 /s，其诊断敏感性和特异性 分别为92.3%、88.9%。结论 DWI结合动 态增强扫描在卵巢囊实性肿瘤良、恶性的 鉴别诊断中有很高的临床应用价值，应常 规用于卵巢囊实性病变的术前检查。

Objective This study aimed to investigate the role of DWI combined with dynamic enhancement in differentiating ovarian tumors with solid and cystic components. Methods The routine MR imaging ,DWI and the ADC values of solid components and dynamic enhancement pictures of 75 ovarian tumors confirmed by surgery and pathology were retrospectively analyzed. Of the 75 patients, there were 39 cystadenomas (benign group) and 36 cystadenocarcinomas (malignant group). The mean ADC value of solid component were calculated and analyzed statistically. Results The mean ADC values of benign group was (1.62±0.24)×10-3mm2 /s, in malignant group was (0.92±0.15） ×10-3mm2 /s,There were found to be significantly different (t=-14.999, P＜0.001).The accuracy was 0.842, sensitivity was 94.44%,specificity was 89.74%,positive predictive value of 89.47%, and negative predictive value of 94.59% when conventional MR imaging combined with DWI. ROC analysis indicated that a cutoff ADC value of 1.26×10-3 mm2 /s was associated with 92.3% sensitivity and 88.9% specificity. Conclusion DWI combined with dynamic enhancement has high clinical application value in differential diagnosis of benign and malignant ovarian tumors, so it should be used in the preoperative examination of ovarian cystic and solid lesions.