| Objective: To explore the qualitative diagnostic value of DWI signal intensity value and ADC value in the ovarian lesions cystic and solid components;analysis of the composition of ovarian cystic lesion DWI signal intensity value and ADC value can value for the differential diagnosis of cystic fluid with different properties.Materials and methods: The patients who were for the pelvic mass and been diagnosised by US or CT of ovarian tumors,and underwent surgery in one week,meanwhile with histopathological results were selected in the study from June 2015 to February 2016.According to the inclusion criteria and exclusion criteria,there are 42 patients eligible,22 cases of benign tumors,including 11 cases of serous cystadenomas,6 cases of mucous capsule adenomas,4 cases of annex inflammatory lesions,and 1case of benign Brenner tumor;20 cases of malignant tumors,including 10 cases of mucous cystadenocarcinomas,7 cases of serous cystadenocarcinomas,2 endometrioid adenocarcinoma and 1 case of borderline serous cystadenocarcinoma.All the patients who were taken surgery in our hospital and undergone MRI before surgery,including conventional MRI(transverse T1 WI,transverse T2 WI,transverse position T2 WI SPAIR)and transverse DWI(b=0,800 s/mm2).The images were transmitted to Philipspost-processing workstation after scanning,and the ADC maps were gotten from DWI(b = 0,800 s/mm2)images on the Philips Extend software.Based on T1 WI,T2WI and T2 WI SPAIR images,to identify tumor part of cystic and solid components,and selected the ROI on DWI and ADC maps,then measured the DWI signal intensity value and ADC values.On the basis of histopathological results,the cystic and solid components were respectively divided into benign and malignant groups.First of all,according to the conventional MRI morphological performance make the qualitative diagnosis of each patient's ovarian pathological changes,and compared with pathological results,calculated the sensitivity,specificity,positive predictive value and negative predictive value.Secondly,respectively to compare cystic part and solid part between ovarian benign and malignant lesions of DWI signal intensity value and ADC values and using ROC curve to draw the best threshold value of diagnosis of benign and malignant ovarian lesions.Again,according to the results of histopathological,cystic part into three groups of mucous,serous and inflammatory,comparison between the three groups of DWI signal intensity value and ADC values.Finally,the serous and mucinous group was compared between benign and malignant cystic department DWI signal intensity value and ADC values.Results:(1)Conventional MRI signs for malignant ovarian lesions diagnostic sensitivity of 95%,specificity of 45.5%,positive predictive value was61.3%,negative predictive value of 90.9%;(2)The DWI signal intensity value and ADC value in ovarian cystic part of benign and malignant respectively 141.90±49.50/2.34±0.53×10-3mm2/s,126.14±33.50/2.50±0.25×10-3mm2/s,there was no statistically significant difference(P>0.05).(3)The DWI signal intensity value and ADC value in ovarian solid part of benign and malignant respectively143.46±24.09/ 1.65±0.16×10-3mm2/s?203.85±46.83/1.2±0.16×10-3mm2/s,the difference was statistically significant(P<0.001).(4)When the DWI signal intensity value was taken threshold value of 159.4,identification of benign and malignant ovarian lesions sensitivity of 88.5%,specificity of 83.3%,the area under the curve is 0.888;When the ADC values was taken threshold value of 1.42×10-3mm2/s,identification of benign and malignant ovarian lesions sensitivity of 92%,specificity of 91.7%,the area under the curve is 0.973.(5)The DWI signal intensity value and ADC value in ovarian cystic part of mucous,serous and inflammatory respectively98.9±22.62/2.69±0.14×10-3mm2/s,156.73±31.52/2.35±0.26×10-3mm2/s,197.92±24.02/1.29±0.15×10-3mm2/s,the difference was statistically significant(P<0.05);the DWI signal intensity value: inflammatory >mucous > serous;the ADC value: inflammatory < mucous < serous;(6)The DWI signal intensity value and ADC value in cystic part of serous cystic adenoma and serous cystadenocarcinoma respectively98.12±23.38/2.70±0.16×10-3mm2/s,99.01±23.04/99.01±23.04×10-3mm2/s,there was no statistically significant difference(P>0.05).(7)The DWI signal intensity value and ADC value in cystic part of mucinous cystic adenoma and mucinous cystadenocarcinoma respectively171.32±31.95/2.32±0.26×10-3mm2/s,142.87±24.61/2.47±0.16×10-3mm2/s,the difference was statistically significant(P<0.05).Conclusion: The application of DWI quantitative parameters in ovarian lesions solid part is helpful to qualitative diagnosis of ovarian lesions;Ovarian tumor cystic fluid of water molecule diffusion has little relationship between benign and malignant,and related to the nature of the fluid;The application of DWI quantitative parameters in ovarian lesions cystic part are helpful to provide a certain basis of differential diagnosis of cystic fluid. |
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