目 的 探讨表观弥散系数 (apparent diffusion coefficient ADC)值对卵巢上皮癌患者盆腔淋巴结 的定性诊断价值。 方 法 回顾性分析 纳入研究的37例卵巢上皮癌患者，术 前行3.0T常规磁共振成像(magenetic resonance imaging, MRI)及弥散加权成 像(diffusion-weighted imaging, DWI) (弥散系数b=0、800s/mm2 )扫描；术后比 对病理及影像，鉴别盆腔转移性淋巴结和 非转移性淋巴结，对两组相关临床和病 理因素进行分析，并测量每一枚淋巴结 的ADC值(MeanADC、MinADC、MaxADC)、 径线(短径、长径、短长径比)，行受试 者工作特征曲线(receiver operator characteristic curve, ROC)分析各自 的诊断效能。结果 两组间肿瘤分化程 度、临床分期、脉管癌栓、输卵管侵 犯、大网膜转移以及腹水的差异有统计 学意义(P＜0.05)，而肿瘤部位间的差异 无统计学意义(P＞0.05)。两组淋巴结的 MeanADC、MinADC、MaxADC值、短径及短 长径比差异均有统计学意义(P＜0.05)， 而两组淋巴结长径差异无统计学意义(P＞ 0.05)，其中MaxADC值的ROC曲线下面积 (area under curve ,AUC)最大为0.976。 MaxADC=1.082×10-3mm2 /s作为鉴别淋巴 结转移的阈值，敏感性和特异性分别为 91.1%和93.2%。结论 ADC值对盆腔转移性 淋巴结诊断效能明显高于淋巴结径线。

Objective To evaluate the diagnostic value of diffusion-weighted imaging(DWI) for the diagnosis of lymph node metastasis in patients with epithelial ovarian cancer. Methods The preoperative routine MR imaging, DWI (b=0,800s/mm2 ) and the ADC values of lymph node pictures of 37 cases of epithelial ovarian cancer were analyzed retrospectively. The postoperative pathology and imaging were compared, and the metastatic and non-metastatic lymph nodes were confirmed by pathology after operation. The clinical and pathological factors of the two groups were analyzed. The ADC(MeanADC, MinADC, MaxADC) values of each lymph node were measured and analyzed statistically including short-axis, long-axis and mean diameters. Receiver operator characteristic curve (ROC) was used to analyze the respective diagnostic efficiency. Results There was statistical difference in differentiation degree of tumor cell, clinical stage, vascular invasion, fallopian tube invasion, omentum majus invasion and presence of ascites between the two groups (P<0.05) and the differences between tumor site has no statistical significance (P>0.05). There was statistical difference in MeanADC, MinADC and MaxADC values, short diameter and short/length ratio of lymph nodes. While the difference in length diameter of lymph node between the two groups was not statistically significant (P>0.05).The AUC of the MaxADC (0.976) was greater than that of the other ADC-based criteria and all size-based criteria. And with 1.082×10-3mm2 / s as a threshold to identify lymph node metastasis, its sensitivity and specificity were 91.1% and 93.2%. Conclusion The diagnostic efficacy of ADC value in pelvic metastatic lymph nodes was significantly higher than that the diameter of lymph node.