The Value Of DWI Combined With Serum CA125 In The Diagnosis Of Ovarian Tumor

Objective To investigate the diagnosis value of magnetic resonance diffusion-weighted imaging combined with serum CA125 in ovarian tumors. And using apparent diffusion coefficient (ADC) and CA125 as a semi-quantitative and quantitative indicators, to study the diagnosis and differential diagnosis of ovarian tumors.Methods Siemens 1.5T MRI systems for clinical diagnosis of 117 cases of ovarian tumor patients underwent preoperative MRI examination and determination of serum CA125, all patients were confirmed by operation and pathology. We analyzed the preoperative MRI and serum CA125 data of all, and then we measured the ADC value in cystic and solid part of ovarian tumors. Application of SPSS19.0 package of all the data for statistical processing, we compared the value of ovarian benign and malignant tumors through Independent-Sample T Test, and used receiver operating characteristic curve (ROC), then to classify the ADC threshold of benign and malignant solid tumors. Ovarian cystic and solid tumors were analyzed with One-Way ANOVA. By using Pair-Sample 2 Test Kappa Test, serum CA125^ MRI and DWI+CA125 were respectively compared with pathology.Results There was no significant difference (P>0.05) between the ADC value comparison about cystic part of ovarian benign and malignant tumors, but there was a significant difference (P<0.05) between the ADC value comparison about solid part of ovarian benign and malignant tumors, and the area under the ROC curve was 0.842, and the best threshold for benign and malignant solidtumorswas 1.0759mm2/s; the whole group of ovarian cystic tumors had a significant statistical significance (P<0.05), multiple comparison analysis between the groups, ovarian chocolate cyst had a statistical significance (P<0.05) compared with the rest groups(malignant ovarian tumors、ovarian cystic mature teratoma、ovarian serous cystadenoma、ovarian mucinous cystadenoma、ovarian corpus luteum cyst with hemorrhage and ovarian simple cyst),ovarian corpus luteum cyst with hemorrhage had a statistical significance (P<0.05) compared with the rest groups(malignant ovarian tumors、ovarian cystic mature teratoma、ovarian Serous cystadenoma、ovarian mucinous cystadenoma、ovarian chocolate cyst、and ovarian simple cyst); In addition to the ovarian chocolate cys、ovarian corpus luteum cyst with hemorrhage, malignant ovarian tumors had no statistical significance (P>0.05)compared with the rest groups(ovarian cystic mature teratoma、ovarian serous cystadenoma、ovarian mucinous cystadenoma and ovarian simple cyst); in addition to ovarian malignant tumor, ovarian cystic mature teratoma had a statistical significance (P<0.05) compared with the rest groups(ovarian serous cystadenoma、ovarian mucinous cystadenoma、ovarian chocolate cyst、ovarian corpus luteum cyst with hemorrhage、and ovarian simple cyst); the ADC value of ovarian serous cystadenoma、 ovarian mucinous cystadenoma and ovarian simple cyst respectively had no statistical significance(P>0.05). the whole group of ovarian solid tumors had a significant statistical significance (P<0.05), multiple comparison analysis between the groups,the ADC value of ovarian malignant tumors、ovarian thecoma and ovarian fibrous tumor respectively had no statistical significance(P>0.05); the ADC value of ovarian struma、ovarian serous cystadenoma and ovarian mucinous cystadenoma respectively had no statistical significance(P>0.05). Serum CA125、MRI and DWI+serum CA125 were respectively compared with pathology. In serum CA125 the diagnosis, the sensitivity, specificity, accuracy and Youden index were 71.1%,88.6%,62.0% and 33.1%, respectively. In the MRI diagnosis, the sensitivity, specificity, accuracy and Youden index were 73.7%,88.6%,83.8% and 62.3%, respectively. In the DWI+serum CA125 diagnosis, the sensitivity, specificity, accuracy and Youden index were 84.2%,96.2%,92.3% and 80.4%, respectively. In the coefficient, DWI+ serum CA125 (0.883)>MRI (0.627)>CA125 (0.255). Show that DWI+serum CA125 was more close to pathological diagnosis between two ways.Conclusion DWI can be a qualitative and quantitative diagnosis of ovarian tumors, especially b=800 s/mm2, which has important significance to identify the solid part of ovarian benign and malignant tumors,and with 1.0759mm2/s as a threshold for the solid part of ovarian benign and malignant tumors,its sensitivity and specificity are 70.3%,78.4%.But DWI is still controversial in differentiating cystic part of ovarian benign and malignant tumors.Serum CA125 is an important primary screening method for the diagnosis of ovarian cancer with high sensitivity,but the specificity and accuracy is not high. DWI and serum CA125 combined diagnosis ovarian benign and malignant tumors can make up the shortages from a sigle check method, and the sensitivity, specificity and accuracy were significantly improved, which can provide an important basis for early diagnosis of ovarian tumors.