Study The Clinical Value Of DCE-MRI In Normal Ovary And Cystic-solid Ovarian Masses

ObjectiveTo evaluate the feasibility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in normal ovaries at different menstrual cycle, and to observe the characteristics of3.0T DCE-MRI parameters and time-intensity curve in normal ovaries at different menstrual cycle. To prospectively evaluate the values of DCE-MRI as a functional MR for differentiation different cystic-solid ovarian masses, analyzing DCE-MRI quantitative parameters characteristics. For another, to explore the differential diagnostic efficacies methods, selecting the optimal examination method to diagnose cystic-solid ovarian masses.Subjects and MethodsPelvic MR plain scan and DCE-MRI of the normal ovaries of33healthy female volunteers were obtained with Siemens MAGNETOM Trio Tim3.0T MRI scanners. Meanwhile87cases were and examined using routine MR+DWI and fat-saturated DCE-MRI sequence between November and January in2014in this study, at last48cases were included. The TIC, Ktrans, Kep and Ve values of ovarian mesenchyme and masses solid content were obtained from Tissue4D software at Siemens Syngo postprocessing workstation. The ovarian masses pathologies were recorded within10days after the examination, then all subjects were divided into3groups according to pathology: Group1, benign; Group2, borderline; Group3, malignant.The independent-sample T test were used for comparing Ktrans values, Kep values and Ve values between different menstrual cycle ovarian mesenchyme. The diagnostic efficiency of DWI, DCE-MRI and combined were compared, then the sensitivity, specificity, NPV, PPV of TIC between different groups were calculated and compared respectively. ADC, Ktrans, Kep and Ve were determined separately for the ovarian tumors solid composition and compared among3groups. Meanwhile, the receiver operating characteristic (ROC) curves was used to analyze the differential diagnostic efficacies of Ktrans, Kep, Ve and ADC values of ovarian tumors solid composition for different ovarian masses, and then confirm the optimal diagnostic threshold value. Results(1) The corresponding TIC shape of different menstrual cycle ovarian mesenchyme was similar with each other (P>0.05), all of them were I type curve.(2) The Ktrans values of normal ovarian mesenchyme at follicular and luteal phase were0.213±0.129(min-1)、0.189±0.124(min-1) respectively; The Kep values of normal ovarian mesenchyme at follicular and luteal phase were0.237■0.103(min-1)、0.248±0.14(min-1); the Ve values were1.692±1.365、1.575±1.085respectively, both Ktrans and Ve values of different menstrual cycle were without statistical significance.(3) The sensitivity, specificity, NPV, and PPV of DWI were68.18%,69.23%,72%,65.22%, respectively; The sensitivity, specificity, NPV, and PPV of DCE-MRI were76.19%,74.07%,80%,69.57%, respectively; The sensitivity, specificity, NPV, and PPV of DWI+DCE were85.72%,100%,86.96%,100%, all of the indicator were higher than the others.(4) ADC values of malignant masses solid composition were lower than benign masses (P<0.01), but the ADC values of borderline masses solid composition compared to benign and malignant masses were without significant difference (P>0.05).(5) Most benign ovarian masses presented I type TIC, but borderline and malignant masses mainly presented III type TIC The TIC difference between benign and malignant had statistical significance (P<0.05), but without significant variation between borderline and malignant masses (P>0.05).(6) Ktrans values of different ovarian tumors solid composition had statistical significance (P<0.05); but there were no significant variation of Kep and Ve values between different masses (P>0.05).(7) ADC values, Ktrans values, Kep values and Ve values could distinguish benign and malignant masses, and the sensitivity, PPV, NPV were all more than60%; Kep values couldn’t distinguish borderline and malignant masses; Ve values couldn’t distinguish benign and borderline masses.Conclusion:This study shows the feasibility of normal ovarian mesenchyme DCE-MRI with3.0T MRI. The Ktrans, Kep and Ve values of normal ovarian mesenchyme were obtained in this study provided reference value to ovarian tumors. DCE-MRI is a promising way to differentiate cystic-solid ovarian masses noninvasively, and can quantitatively and visually distinguish different ovarian masses, and the Ktrans value is the optimal diagnostic efficiency to differentiate ovarian masses.