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

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