目的 探讨多模型体素不相干运 动(IVIM)成像联合血清CA125对卵巢占位 病变的定性诊断价值。方法 回顾性分析 31例良性卵巢肿瘤患者和30例恶性卵巢 肿瘤患者的IVIM影像资料和血清CA125水 平，比较良性肿瘤组与恶性肿瘤组单指 数、双指数、拉伸指数模型各参数值以 及血清CA125水平的差异，采用受试者工 作特征(ROC)曲线评价各参数值的阈值及 诊断效能，并分析各参数值与CA125表达 水平的相关性。结果 良性肿瘤组的ADCstand、ADC-slow、DDC及α值均高于恶性 肿瘤组，ROC曲线下面积分别是0.988、 0.985、0.946、0.742，诊断阈值分别为 1.230×10-3mm2 /s、0.913×10-3mm2 /s、 1.230×10-3mm2 /s、0.742；恶性肿瘤组中 ADC-stand、ADC-slow、DDC值与CA125表 达水平呈负相关（r=-0.773、-0.519、- 0.507，P均＜0.05）；MR+IVIM+CA125鉴 别卵巢良、恶性肿瘤的灵敏度为93.33%， 特异度为93.54%；准确度93.44%，约登指 数86.87%。结论 多模型IVIM序列联合血 清CA125可以为卵巢肿瘤的定性诊断提供 可靠的参考指标。

Objective To investigate the value of intravoxel incoherent motion(IVIM) imaging combined with serum CA125 in the qualitative diagnosis of ovarian occupying lesions. Methods Retrospectively analyzed the IVIM images and serum CA125 of 31 patients with benign ovarian tumors and 30 patients withmalignant ovarian tumors, compared the differences of the parameters in monoexponential, biexponential and stretched-exponential models and serum CA125 level between the two groups,evaluated the thresholds and diagnostic efficiency of the parameters by the receiver operating characteristic (ROC) curve,and analyzed the correlation between the parameters and serum CA125. Results The ADC-stand, ADC-slow, DDC and α values in benign ovarian tumors were higher than those in malignant ovarian tumors, and the area under the ROC curve was 0.988, 0.985, 0.946, 0.742. The diagnostic thresholds were 1.230×10-3mm2 /s, 0.913×10-3mm2 /s, 1.230×10-3mm2 /s, 0.742, respectively. The ADC-stand, ADC-slow and DDC values in malignant tumor group was negatively correlated with the level of serum CA125(r=-0.773, -0.519, -0.507, P均＜0.05). The sensitivity of MR+IVIM+CA125 in the differential diagnosis of benign and malignant ovarian tumors was 93.33%, the specificity was 93.54%, the accuracy was 93.44%, Youden index was 86.87%. Conclusion The combination of multi-model IVIM parameters and serum CA125 level can provide a reliable reference marker for qualitative diagnosis of ovarian tumors.