目的研究3.0T MRI多b值弥散加 权成像联合ADC值对卵巢癌诊断的价值。 方法 收集我院2015年1月至2017年12月共 85例卵巢肿瘤患者病例资料，均经手术 病理证实，在我院行MRI检查，包括MRI 平扫、多b值弥散加权成像及增强扫描。 以术后病理结果为金标准，比较多b值弥 散加权成像上良恶性病变ADC值，并绘制 不同b值弥散加权成像上ADC值诊断卵巢肿 瘤的ROC曲线，计算ROC曲线下面积、最大 约登指数、最佳阈值、灵敏度、特异度、 阳性预测值、阴性预测值、准确性。结 果 85例卵巢肿瘤患者经术后组织病理证 实，良性病变50例，恶性病变35例。不同 b值下良性病变组ADC值均显著高于恶性病 变组(P＜0.05)。根据ROC曲线分析，50s/ mm2 、100s/mm2 、500s/mm2 、1000s/mm2 、 1500s/mm2等5个b值的曲线下面积分别为 0.817、0.840、0.873、0.914、0.882， 最佳阈值为1.499、1.336、1.240、 1.081、0.957，灵敏度86.8%、88.9%、 90.1%、93.4%、90.7%，特异度为81.0%、 83.4%、85.3%、90.2%、88.6%。结论 多b 值弥散加权成像是常规MRI重要补充，联 合ADC值对卵巢肿瘤良恶性鉴别具有一定 价值。当b值取1000s/mm2 时具有最佳诊断 效能，此时ADC值诊断阈值为1.081×10- 3 mm2 /s。

Objective To study the diagnostic value of 3.0T MRI multi B diffusionweighted imaging combined with ADC in ovarian cancer. Methods The clinical data of 85 patients with ovarian tumors who were admitted to the hospital from January 2015 to December 2017 were collected and all were confirmed by surgery and pathology. MRI was performed, including MRI plain scan, diffusion-weighted imaging with multiple b values and enhanced scan. With postoperative pathological results as the golden standard, ADC values of benign and malignant lesions on diffusion-weighted images with multiple b values were compared, and ROC curve of ADC value in diagnosis of ovarian tumors on diffusion-weighted images with multiple b values were drawn. The area under the ROC curve, the maximum Youden index, the optimal threshold, sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. Results Postoperative histopathology confirmed that in 85 cases of ovarian tumors, there were 50 cases of benign lesions and 35 cases of malignant lesions. ADC values of the benign lesion group under different b values were significantly higher than those of the malignant lesion group (P<0.05). According to the analysis of ROC curve, areas under the curve of 5 b values (50s/mm2 , 100s/mm2 , 500s/mm2 , 1000s/mm2 and 1500s/mm2 ) were 0.817, 0.840, 0.873, 0.914 and 0.882, respectively, the optimal thresholds were 1.499, 1.336, 1.240, 1.081 and 0.957, respectively, the sensitivities were 86.8%, 88.9%, 90.1%, 93.4%and 90.7%, respectively, and the specificities were81.0%, 83.4%, 85.3%, 90.2% and 88.6%, respectively. Conclusion The diffusion-weighted 3.0 T MRI with multiple b values is an important supplement for conventional MRI. The combined use of ADC value is of certain value for the differential diagnosis of benign and malignant ovarian tumors. When the b value is 1000s/mm2 , the diagnostic efficiency is the best, and the diagnostic threshold of ADC value is 1.081×10-3mm2 /s.