目的 探讨磁共振动态增强(DCEMRI)和扩散加权成像(DWI)在卵巢癌临床 分期诊断中的价值。方法 回顾性分析我 院2014年4月-2016年4月收治的50例卵巢 癌患者(卵巢癌组)和同期健康体检的50例 健康志愿者(正常组)临床资料。两组受试 者均接受DCE-MRI和DWI检查，比较其DCEMRI定量参数[容量转移常数(Ktrans)、速率 常数(Kep)、血管外细胞外容积分数(Ve)] 及DWI表观扩散系数(ADC)值差异。记录不 同临床分期卵巢癌患者各DCE-MRI定量参 数(Ktrans、Kep、Ve)及ADC值差异。经ROC曲 线评价上述参数对卵巢癌临床分期的诊断 效能[曲线下面积(AUC)、敏感度、特异 度、约登指数]。结果 卵巢癌组ADC值明 显低于对照组，Ktrans、Kep、Ve等DCE-MRI 定量参数值则明显高于对照组，差异均有 统计学意义(P＜0.05)。不同临床分期卵 巢癌患者DCE-MRI定量参数及ADC值比较， 均有统计学意义(P＜0.05)。卵巢癌临 床分期与DCE-MRI定量参数(Ktrans、Kep、 Ve)均呈正相关(r=0.523,0.483,0.356， P均＜0.05)，与ADC值则呈负相关(r=- 0.359，P＜0.05)。Ktrans、Kep、Ve与ADC 值诊断卵巢癌临床分期的特异性、敏感 性分别为92.6%、83.7%、70.5%、89.2% 和88.9%、91.6%、53.4%、92.4%。结论 DCE-MRI和DWI均在卵巢癌的临床分期诊断 中有较高应用价值。

Objective To evaluate the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion weighted imaging (DWI) in the diagnosis of clinical stage of ovarian cancer. Methods The clinical data of 50 patients with ovarian cancer (ovarian cancer group) and 50 healthy volunteers (healthy group) who were admitted to our hospital during April 2014 to April 2016 were retrospectively analyzed. Both groups were examined with DCE-MRI and DWI. The DCE-MRI quantitative parameters [volume transfer constant (Ktrans) and rate constant (Kep), extravascular extracellular volume fraction (Ve)] and DWI apparent diffusion coefficient (ADC) values were compared between the two groups and between patients with different clinical stages of ovarian cancer. The diagnostic efficacy [area under the curve (AUC), sensitivity, specificity, Jorden index] of the above parameters in the diagnosis of clinical stage of ovarian cancer was evaluated with ROC. Results The ADC value of ovarian cancer group was significantly lower, and the DCE-MRI quantitative parameters (Ktrans, Kep, Ve) were significantly higher than those of the control group (P<0.05). There were significant differences in DCE-MRI parameters and ADC values between patients with different clinical stages of ovarian cancer (P<0.05). The clinical stage of ovarian cancer was positively correlated with DCE-MRI quantitative parameters (Ktrans, Kep, Ve) (r=0.523, 0.483, 0.356, P<0.05), and negatively correlated with ADC values (r=-0.359, P<0.05). The specificities and sensitivities of Ktrans, Kep, Ve and ADC in the diagnosis of clinical stage of ovarian cancer were 92.6%, 83.7%, 70.5%, 89.2% and 88.9%, 91.6%, 53.4%, 92.4%, respectively. Conclusion Both DCE-MRI and DWI have high clinical value in the diagnosis of clinical stage of ovarian cancer.