The Value Of MRI And DWI In The Diagnosis Of Ovarian Tumors Research

Objective To compare the clinical manifestations,CA125 detection,ultrasound and MRI in the diagnosis of benign and malignant ovarian tumor differential diagnosis efficiency.To evaluate the value of MRI and DWI in different properties ovarian tumors qualitative diagnosis and differential diagnosis.To explore the benign and malignant ovarian swollen ADC values measured value in the differential diagnosis and determine the best threshold.Finally for clinical preoperative evaluation of ovarian tumors choose the optimal path.Subjects and Methods Retrospective analysis 48 patients with ovarian tumors,examined by MRI and confirmed by surgery pathology in the third affiliated hospital of Zhengzhou University between October 2014 and October 2015.The 48 patients age range 10 to 78 years old,average 48.3 years.Then all the patients ovarian tumors were removed surgically and had the histopathological results.According to the histopathological results as the golden standard,48 patients with ovarian tumors can be divided into benign and malignant tumors(1,2)in the two groups,30 cases of benign group,a total of 32 lesions;18 cases of malignant group,a total 24 lesions.Among them 1 case border group as malignant ovarian tumors. First of all,analysis this study a variety of ovarian tumors distribution characteristics in different ages,compare with benign and malignant ovarian tumors positive clinical manifestations and the positive rate.Secondly, analysis of benign and malignant group and positive rate of CA125 values.Then,analysis of 48 cases of ovarian tumors ultrasound diagnosis and compared with the pathological results and statistics the sensitivity,specificity,negative predictive value and positive predictive value and accuracy.Next,analysis this study of patients with ovarian tumors MRI and DWI data can,combined with mass MRI scan,DWI,and enhanced MRI scan imaging,analysis of the MRI manifestation of benign and malignant ovarian tumors and make the qualitative diagnosis,comparison with the pathological results it is concluded that the sensitivity,specificity,negative predictive value,positive predictive value and accuracy.Finally,on the basis of histopathological qualitative,measure the ADC values of the benign and malignant groups in DWI,analysis and compare statistically significant of ADC value differences between the two groups.And adopt the receiver-operating characteristic curve(ROC curve)to determine the best threshold in benign and malignant ovarian tumors in the differential diagnosis value,and draw the corresponding specificity,sensitivity,negative predictive value,positive predictive value and accuracy.Finally, compare the values of clinical manifestation,CA125 detection, ultrasound, magnetic resonance imaging(MRI) and DWI in benign and malignant ovarian tumors in the differential diagnosis.Results(1) Gets from benign or malignant tumor onset age,in this study,48 patients with ovarian tumors,10-76 years old with benign,an average of 47.6±13.4 years old; patients with malignant 12-78 years old,an average of 48.5±10.8 years old. There are no statistically significant difference between the two groups(P>0.05).(2) In this study,48 patients with ovarian tumors,18 cases have no obvious positive symptoms and signs,accounting for 37.5%.30 cases have related positive symptoms and signs for the first time to see a doctor, accounting for 62.5%.Positive signs and symptoms manly show for lower abdomen bag piece, discomfort, pain, menstrual disorders or postmenopausal vaginal bleeding three aspects and so on.In 30 cases of benign ovarian tumor,10 cases have positive symptoms or signs,33.3% of the virtuous person.In 18 cases of malignant ovarian tumors,12 cases with positive symptoms and signs,66.7% of the vicious person.Being tumor incidence of positive clinical manifestations,was statistically significant difference between the two groups(P<0.05).(3) In this study the serum CA125 level less than or equal to 35U/ml of as for normal reference value,positive standard for more than 35U/ml.After statistics,it is found that positive for 10 cases accounted for 20.8% of all 48 cases ovarian tumors in this study.One,case is benign tumor,for theca fibroma(CA125 level 116.5U/ml),3.3% of all benign tumors.9 cases malignant tumors are all form ovarian epithelial carcinoma,accounted for 69.2% of all ovarian epithelial carcinoma,50% of malignant group of this research,and the value of CA125 in the 9 positive(average 743.7±12.3U/ml) are significantly higher than the levels of CA125 theca fibroma positive.This study of benign and malignant groups differences have significant statistical significance in CA125 positive rate(P<0.01).(4)To this study,48 patients of ultrasound diagnosis with postoperative histopathological results showed that after comparing the 8 cases of benign tumor diagnosed as malignant,2 cases of malignant tumor diagnosed as benign,sensitivity of 88.9%, specificity of 73.3%,the accuracy was 79.2%,positive value was 66.7%, negative predictive value of 91.7%.(5) After comparing MR diagnosis with histological pathology results it was found that the 6 cases of benign diagnosis of malignant tumor,1 case of malignant tumor diagnosed as benign. The sensitivity of MRI in the diagnosis of ovarian malignant tumors was 94.4%, specificity of 80.0%,the accuracy was 85.4%,positive predictive value was 73.9%,negative predictive value of 96.0%.After comparing, MRI in the diagnosis of ovarian malignant tumor diagnosis efficiency is better than that of ultrasound.Benign and malignant group DWI difference of ADC values can have a significant statistical significance(P<0.01),and after the ROC curve drawing,benign and malignant ovarian tumor ADC value best threshold value in differential diagnosis was 1.328x10-3mm2/s.Which can obtain satisfactory sensitivity,accuracy,positive predictive value and negative predictive value and other indicators.ConclusionsClinical manifestations and ultrasound can be used as screening ovarian tumors, CA125positive suggest ovarian cancer possibilities, joint MRI and DWI can improve the accuracy of the qualitative diagnosis of ovarian tumors. Integrated application of these methods, it can be for clinical preoperative evaluation of ovarian tumors to provide comprehensive and accurate information.