| BackgroundOvarian tumor is a kind of gynecological more common malignant tumor disease,its incidence is second only to uterine body cancer and cervical cancer.The risk of ovarian cancer is under age 65.The incidence of ovarian cancer is 0.36% in developing countries and 0.64% in developed countries.The incidence rate in China is 8.14 per 100,000 and the mortality rate is 3.13 per 100,000.The clinical symptoms of most patients are non-specific,and due to the poor effectiveness of current screening regimens for the disease,the diagnosis is usually at a late stage with poor prognosis.Therefore,for ovarian cancer patients early diagnosis,early treatment,the prognosis of patients will be of great va!MethodsPelvic MRI and DCE-MRI were performed in 33 volunteers with normal ovarian tissue(in different menstrual cycles).Conventional pelvic MRI,DWI and DCE-MRI were performed in 48 patients with ovarian tumor.After the scanning,DCE-MRI images and DWI images of the normal group and the tumor group were imported into the magnetic resonance image post-processing workstation to measure relevant quantitative parameters.To observe the changes of DCE-MRI quantitative parameters and the characteristics of time-signal curve of normal ovary in different periods of menstrual cycle.Taking pathological results as the gold standard,the imaging manifestations of the tumor group were retrospectively analyzed,the diagnostic efficacy of DCE-MRI combined with DWI for ovarian tumors of different properties was compared,and the variation regularity and clinical significance of functional evaluation indexes were analyzed.Results1.In the DCE-MRI image of normal ovary,the ovarian stroma presented progressive high signal with obvious enhancement,while the ovary presented no enhancement with low signal.2.The normal ovarian interstitial time-signal curve(TIC)of different menstrual cycles showed a gradual rise,that is,the i-shaped curve;There was no statistical difference in morphology(P>0.05).3.There was no statistical difference in DCE-MRI quantitative parameters(Ktrans value,Kep value,Ve value)of normal ovarian stroma in different menstrual cycles(p>0.05).4.There were significant statistical differences in TIC curve morphology between benign ovarian tumors,borderline ovarian tumors and ovarian malignancies.5.The ADC value of benign ovarian tumors was significantly higher than that of malignant ovarian tumors.6.Ovarian malignant tumor Ktans value > junction tumor Ktans value > benign tumor Ktans value,for Kep value and Ve value of the difference is not obvious.7.There was a statistical difference between Ktrans value,ADC value and Ve value in differentiating benign from borderline and malignant ovarian tumors(P< 0.05).However,there was no statistical significance between Ktrans value and ADC value and Ve value and Kep value(P>0.05).8.In the differential diagnosis of benign and malignant ovarian tumors,the optimal thresholds for ADC values,Ktrans,Kep and Ve values were 1.174×10-3 mm2/s,0.123min-1,and 0.262min-1,0.549,respectively.In the differential diagnosis of ovarian borderline and malignant tumors,the optimal thresholds for ADC values,Ktrans,Kep and Ve values were 0.933×10-3mm2/s,0.212 min-1,0.338min-1 and 0.634,respectively.In the differential diagnosis of ovarian borderline tumors,the optimal threshold value of Ktrans value is 0.108 min-1.ConclusionThe hemodynamic characteristics of dce-mri in normal ovarian interstitium were independent of the menstrual cycle.DCE-MRI combined with DWI has a high diagnostic efficiency in differentiating benign and malignant ovarian cystic solid tumors of different types. |
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