卵巢癌患者DCE-MRI联合高b值DWI检查的表现分析

doi:10.3760/cma.j.issn.1007-1245.2024.10.024

国际医药卫生导报 ›› 2024, Vol. 30 ›› Issue (10): 1703-1707.DOI: 10.3760/cma.j.issn.1007-1245.2024.10.024

卵巢癌患者DCE-MRI联合高b值DWI检查的表现分析

唐敏丽¹ 张涛¹ 蔡雷¹ 刘连锋¹ 白江涛¹ 任召¹ 杨宁丽² 马旭阳¹ 唐海利²

¹延安大学咸阳医院CT/MRI室，咸阳　712000；²中国人民解放军空军军医大学第二附属医院普通外科，西安　710038

收稿日期:2024-01-11 出版日期:2024-05-15 发布日期:2024-06-03
通讯作者: 马旭阳，Email：zzhixh@163.com
基金资助:
陕西省自然科学基础研究计划（2022JM-604）

Analysis of findings of DCE-MRI combined with high B-value DWI in ovarian cancer patients

Tang Minli¹, Zhang Tao¹, Cai Lei¹, Liu Lianfeng¹, Bai Jiangtao¹, Ren Zhao¹, Yang Ningli², Ma Xuyang¹, Tang Haili²

¹CT/MRI Room, Xianyang Hospital, Yan'an University, Xianyang 712000, China; ²General Surgery, The Second Affiliated Hospital of the Chinese People's Liberation Army Air Force Medical University, Xi'an 710038, China

Received:2024-01-11 Online:2024-05-15 Published:2024-06-03
Contact: Ma Xuyang, Email: zzhixh@163.com
Supported by:
Natural Science Basic Research Program of Shaanxi Province (2022JM-604)

摘要/Abstract

摘要：

目的　分析卵巢癌患者磁共振动态增强（DCE-MRI）联合高b值弥散加权成像（DWI）检查的表现。方法　回顾性分析延安大学咸阳医院在2020年6月至2023年6月收治的50例确诊为卵巢癌患者的临床资料，作为观察组，并选取同期体检健康者50例为对照组。对照组年龄（33.58±5.47）岁；观察组年龄（33.37±5.53）岁，国际妇产科联盟（FIGO）分期Ⅰ期8例、Ⅱ期25例、Ⅲ期12例、Ⅳ期5例。两组受试者均接受DCE-MRI及高b值DWI检查，比较两组受试者的DCE-MRI定量参数，包括容量转移常数（Ktrans）、速率常数（Kep）、血管外细胞外容积分数（Ve）；观察并比较两组DWI表观弥散系数（ADC）情况；绘制受试者操作特征曲线（ROC），计算曲线下面积（AUC）评估DCE-MRI联合高b值DWI检查对卵巢癌患者的诊断效能。采用F检验。结果　观察组Ktrans、Kep、Ve分别为（0.43±0.05）min、（0.85±0.13）min、（0.75±0.25），均高于对照组的（0.07±0.06）min、（0.27±0.12）min、（0.26±0.16），观察组ADC值为（0.93±0.13）×10^-3 mm²/s，低于对照组的（1.53±0.23）×10^-3 mm²/s，差异均有统计学意义（均P<0.05）；Ⅳ期患者Ktrans、Kep、Ve高于Ⅲ期，Ⅲ期高于Ⅱ期，Ⅱ期高于Ⅰ期，Ⅳ期患者ADC值低于Ⅲ期，Ⅲ期低于Ⅱ期，Ⅱ期低于Ⅰ期，差异均有统计学意义（均P<0.05）。经ROC分析，DCE-MRI对卵巢癌不同分期的诊断灵敏度为85.35%，特异度为90.14%，高b值DWI对卵巢癌不同分期的诊断灵敏度为82.45%，特异度为87.14%，DCE-MRI联合高b值DWI对卵巢癌不同分期的诊断灵敏度为94.14%，特异度为95.85%。结论　DCE-MRI联合高b值DWI检查应用于卵巢癌患者具有更高效能，显著优于单项检测；当b值为1 600 s•mm^-2时，结合DCE-MRI对卵巢癌的临床分期诊断具有更高的灵敏度和特异度；作为临床无创诊断辅助手段，两种检查方式可互为补充，避免卵巢癌的误诊，对患者治疗和预后具有重要临床价值。

关键词:

磁共振动态增强, 高b值弥散加权成像, 卵巢癌, 速率常数

Abstract:

Objective　To investigate the findings of dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) combined with high B-value diffusion-weighted imaging (DWI) in patients with ovarian cancer. Methods　Clinical data of 50 patients diagnosed with ovarian cancer (observation group) admitted to Xianyang Hospital, Yan'an University from June 2020 to June 2023 were retrospectively analyzed, and 50 healthy controls during the same period were selected as the control group. The control group was (33.58±5.47) years old; the observation group was (33.37±5.53) years old, with 8 cases in stage Ⅰ, 25 cases in stage Ⅱ, 12 cases in stage Ⅲ, and 5 cases in stage Ⅳ according to the International Federation of Gynecology and Obstetrics (FIGO) stage. Both groups underwent DCE-MRI and high B-value DWI examination. The quantitative parameters of DCE-MRI, including volume transfer constant (Ktrans), rate constant (Kep), and extracellular volume fraction (Ve), were compared between the two groups. The apparent diffusion coefficient (ADC) of DWI was observed and compared between the two groups. The receiver operating characteristic curve (ROC) was plotted and the area under the curve (AUC) was calculated to evaluate the diagnostic efficacy of DCE-MRI combined with high B-value DWI in ovarian cancer patients. F test was used. Results　The values of Ktrans, Kep, and Ve in the observation group were (0.43±0.05) min, (0.85±0.13) min, and (0.75±0.25), which were higher than those in the control group [(0.07±0.06) min, (0.27±0.12) min, and (0.26±0.16)], and the ADC value of the observation group was (0.93±0.13) ×10^-3 mm²/s, which was significantly lower than that of the control group [(1.53±0.23) ×10^-3 mm²/s], with statistically significant differences (all P<0.05). The values of Ktrans, Kep, and Ve ranked as follow: stage Ⅳ > stage Ⅲ > stage Ⅱ > stage Ⅰ, and the ADC value ranked as follow: stage Ⅳ < stage Ⅲ < stage Ⅱ < stage Ⅰ, with statistically significant differences (all P<0.05). According to ROC analysis, the diagnostic sensitivity and specificity of DCE-MRI for different stages of ovarian cancer were 85.35% and 90.14%, the diagnostic sensitivity and specificity of high B-value DWI for different stages of ovarian cancer were 82.45% and 87.14%, and the diagnostic sensitivity and specificity of DCE-MRI combined with high B-value DWI for different stages of ovarian cancer were 94.14% and 95.85%. Conclusions　DCE-MRI combined with high B-value DWI examination has higher efficacy in ovarian cancer patients, which is significantly superior to single detection. When B-value is 1 600 s•mm^-2, combined DCE-MRI has higher sensitivity and specificity for clinical staging diagnosis of ovarian cancer. As an auxiliary means of clinical non-invasive diagnosis, the two examination methods can complement each other, avoiding misdiagnosis of ovarian cancer, have important clinical value for the patients' treatment and prognosis.

Key words:

Dynamic contrast enhanced-magnetic resonance imaging, High B-value diffusion-weighted imaging, Ovarian cancer, Rate constant

唐敏丽张涛蔡雷刘连锋白江涛任召杨宁丽马旭阳唐海利.

卵巢癌患者DCE-MRI联合高b值DWI检查的表现分析 [J]. 国际医药卫生导报, 2024, 30(10): 1703-1707.

Tang Minli, Zhang Tao, Cai Lei, Liu Lianfeng, Bai Jiangtao, Ren Zhao, Yang Ningli, Ma Xuyang, Tang Haili.

Analysis of findings of DCE-MRI combined with high B-value DWI in ovarian cancer patients [J]. International Medicine and Health Guidance News, 2024, 30(10): 1703-1707.

参考文献

[1] 曹冬焱.卵巢癌规范化诊疗与进展[J].中国临床医生杂志,2023,51(3):268-271. DOI:10.3969/j.issn.2095-8552. 2023.03.004.
[2] 马建红,王雄,闫宇,等.葡萄糖代谢对卵巢癌发生发展及其致病机制调控作用的研究进展[J].中国计划生育和妇产科,2023,15(7):18-21. DOI:10.3969/j.issn.1674-4020.2023. 07.05.
[3] 张帆,蔡庆,沈玉英,等.CT和MRI对卵巢癌术前FIGO分期价值的Meta分析[J].中国CT和MRI杂志,2022,20(6):107-110. DOI:10.3969/j.issn.1672-5131.2022.06.035.
[4] Morand S, Devanaboyina M, Staats H, et al. Ovarian cancer immunotherapy and personalized medicine[J]. Int J Mol Sci, 2021, 22(12):6532. DOI: 10.3390/ijms22126532.
[5] 薛柳恋,郑业锟,周园.1.5T DCE-MRI及DWI对卵巢癌术前分期及定位诊断中的价值观察[J].中国CT和MRI杂志,2023,21(5):127-129. DOI:10.3969/j.issn.1672-5131. 2023.05.044.
[6] 中国抗癌协会妇科肿瘤专业委员会.卵巢恶性肿瘤诊断与治疗指南(2021年版)[J].中国癌症杂志,2021,31(6):490-500. DOI:10.19401/j.cnki.1007-3639.2021.06.07.
[7] 林仲秋,谢玲玲,李晶.FIGO 2013卵巢癌、输卵管癌、腹膜癌新分期解读[J].中国实用妇科与产科杂志,2013,29(12):921-923.
[8] An Y, Yang Q. Tumor-associated macrophage-targeted therapeutics in ovarian cancer[J]. Int J Cancer, 2021, 149(1):21-30. DOI: 10.1002/ijc.33408.
[9] 王旭,王柯耀,陈晗,等.卵巢癌相关细胞凋亡通路及治疗性诱导剂的研究进展[J].现代肿瘤医学,2023,31(1):164-168. DOI:10.3969/j.issn.1672-4992.2023.01.031.
[10] 徐焱,赵福香,时园园,等.DCE-MRI定量参数在卵巢癌分期诊断及预后评估中的应用研究[J].实用癌症杂志,2022,37(1):126-129. DOI:10.3969/j.issn.1001-5930.2022. 01.037.
[11] 葛延平,张磊,宋丹.卵巢癌DCE-MRI定量参数与临床病理的相关性分析[J].中国CT和MRI杂志,2022,20(11):98-100. DOI:10.3969/j.issn.1672-5131.2022.11.035.
[12] 刘坤,焦洪斌,杨青.磁共振弥散加权成像联合糖类抗原125对卵巢交界性肿瘤与上皮性卵巢癌的鉴别诊断价值[J].实用临床医药杂志,2023,27(5):31-36. DOI:10.7619/jcmp.20223212.
[13] Gagliardi T, Adejolu M, deSouza NM. Diffusion-weighted magnetic resonance imaging in ovarian cancer: exploiting strengths and understanding limitations[J]. J Clin Med, 2022, 11(6):1524. DOI: 10.3390/jcm11061524.
[14] 林培培,周晓冬,宋伟.子宫内膜癌肿瘤体积与子宫体积比值联合肿瘤ADC值对病理分级的预测价值[J].实用医学杂志,2023,39(23):3071-3075. DOI:10.3969/j.issn.1006- 5725.2023.23.008.
[15] 马丽颖,孙美玉.MRI对上皮性卵巢癌组织学分型的诊断应用[J].国际医学放射学杂志,2022,45(1):89-93. DOI:10.19300/j.2022.Z19176.
[16] 毛咪咪,冯峰.基于肿瘤全域表观扩散系数纹理分析预测上皮性卵巢癌复发的研究[J].中国临床医学影像杂志,2020,31(1):52-56. DOI:10.12117/jccmi.2020.01.013.

卵巢癌患者DCE-MRI联合高b值DWI检查的表现分析

Analysis of findings of DCE-MRI combined with high B-value DWI in ovarian cancer patients

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 7

编辑推荐

Metrics

[1]	岳红陈文华范志刚张淑莲常捷芳. 贝伐珠单抗联合TC方案治疗晚期复发性卵巢癌患者的效果 [J]. 国际医药卫生导报, 2024, 30(7): 1190-1194.
[2]	谢燕陈玉莹江锦鸿. ROMA指数在卵巢癌诊断中临床价值的meta分析 [J]. 国际医药卫生导报, 2023, 29(22): 3224-3230.
[3]	高本雪李绵利耿海涛孙霖. 卵巢癌合并副肿瘤肾病综合征1例 [J]. 国际医药卫生导报, 2023, 29(19): 2794-2798.
[4]	丁佰娟张立伟杨慧崔秀娟李南. IGSF9在上皮性卵巢癌中的表达及对卵巢癌细胞转移能力的影响 [J]. 国际医药卫生导报, 2023, 29(16): 2268-2272.
[5]	隋红梅　贺凤喜　李爱华　李爱峰　王丽　路焕喜. 忧遁草中黄酮苷的分离纯化以及对上皮性卵巢癌抗肿瘤作用的研究[J]. 国际医药卫生导报, 2022, 28(13): 1784-1789.
[6]	张丽丽　隋红梅　贺凤喜　刘丹丹　李爱峰　李爱华. 东北岩高兰提取物对上皮性卵巢癌细胞的凋亡作用及机制探讨[J]. 国际医药卫生导报, 2022, 28(13): 1789-1795.
[7]	万淑琼, 鲍群丽, 黄耿, 姜艳萍, 张青冬, 王楚平. miR-3529-3p通过下调E2F3基因表达抑制卵巢癌SKOV-3细胞增殖的机制研究[J]. 国际医药卫生导报, 2022, 28(1): 24-27.