目的 分析磁共振动态增强成像 (DCE-MRI)与弥散加权成像(DWI)对良性 与恶性囊实性卵巢肿瘤的诊断价值。方 法 收集我院经手术病理证实为囊实性卵 巢肿瘤的120例患者临床资料，所有患者 术前均进行常规MRI扫描、DCE-MRI及DWI 扫描，分析其影像学特征，比较良性与恶 性囊实性卵巢肿瘤表观扩散系数(ADC)、 容量转运参数(Ktrans)、速率常数(Kep)、 血管外细胞外间隙容积比(Ve)，并评估其 诊断效能。结果 120例患者中恶性病变67 例(55.83%)，良性病变53例(44.17%)。 囊实性卵巢恶性肿瘤实性部分ADC值显 著低于良性肿瘤(P<0.05)，囊性部分ADC 值与良性肿瘤无显著差异(P>0.05)。当 ADC=1.20×10-3mm2 /s时，诊断灵敏度和 特异度分别为86.57%、81.13%。囊实 性卵巢恶性肿瘤实性部分Ktrans、 Ke p及 Ve值均显著小于良性肿瘤(P<0.05)。当 Ktrans=0.09min-1时，诊断灵敏度和特异度 分别为83.58%、83.02%。DCE-MRI+DWI对 良性与恶性囊实性卵巢肿瘤的诊断灵敏 度、特异度、准确度、阳性预测值、阴性 预测值依次为94.03%、94.34%、94.17%、 95.45%、92.59%，均高于单独DCE-MRI检 测和单独DWI检测。结论 DCE-MRI+DWI对 良性与恶性囊实性卵巢肿瘤的诊断效能较 好，可作为囊实性卵巢肿瘤术前诊断重要 方法。

Objective To analyze the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) for benign and malignant cystic ovarian tumors. Methods The clinical data of 120 patients with cystic ovarian tumor confirmed by surgery and pathology in our hospital were collected. All patients were treated with routine MRI scan, DCE-MRI and DWI scan, the imaging features were analyzed, the apparent diffusion coefficient (ADC), volume transport parameter (Ktrans), rate constant (Kep), extravascular extracellular space volume ratio (Ve) in benign and malignant cystic ovarian tumors were compared, the diagnostic efficacy was evaluated. Results Among the 120 patients, there were 67 (55.83%) with malignant lesions and 53 (44.17%) with benign lesions. The ADC value of solid part of cystic ovarian malignant tumor was significantly lower than that of benign tumor (P<0.05). There was no significant difference between cystic part ADC and benign tumor (P>0.05). When ADC equaled to 1.20×10-3mm2 /s, the diagnostic sensitivity and specificity were 86.57% and 81.13%, respectively. The Ktrans, Kep and Ve values of solid parts of cystic ovarian malignant tumors were significantly lower than those of benign tumors (P<0.05). When Ktrans equaled to 0.09min-1, the diagnostic sensitivity and specificity were 83.58% and 83.02%, respectively. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value by DCE-MRI combined with DWI for benign and malignant cystic ovarian tumors were 94.03%, 94.34%, 94.17%, 95.45%, and 92.59%, respectively, all higher than the values by DCE-MRI alone and DWI alone. Conclusion DCE-MRI combined with DWI has a good diagnostic effect on benign and malignant cystic ovarian tumors, it can be used as an important method for preoperative diagnosis of cystic ovarian tumors.