Li Hai-Ming, Qiang Jin-Wei, Ma Feng-Hua, Zhao Shu-Hui
Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, 1508 Longhang Road, Shanghai, 201508, China.
Department of Radiology, Nantong Cancer Hospital, Nantong University, Nantong, Jiangsu, 226361, China.
J Ovarian Res. 2017 Jan 14;10(1):4. doi: 10.1186/s13048-017-0302-y.
The study aimed to investigate the utility of dynamic contrast enhanced MRI (DCE-MRI) in the differentiation of malignant, borderline, and benign complex ovarian tumors.
DCE-MRI data of 102 consecutive complex ovarian tumors (benign 15, borderline 16, and malignant 71), confirmed by surgery and histopathology, were analyzed retrospectively. The patterns (I, II, and III) of time-signal intensity curve (TIC) and three semi-quantitative parameters, including enhancement amplitude (EA), maximal slope (MS), and time of half rising (THR), were evaluated and compared among benign, borderline, and malignant ovarian tumors. The types of TIC were compared by Pearson Chi-square χ between malignant and benign, borderline tumors. The mean values of EA, MS, and THR were compared using one-way ANOVA or nonparametric Kruskal-Wallis test.
Fifty-nine of 71 (83%) malignant tumors showed a type-III TIC; 9 of 16 (56%) borderline tumors showed a type-II TIC, and 10 of 15 (67%) benign tumors showed a type-II TIC, with a statistically significant difference between malignant and benign tumors (P < 0.001) and between malignant and borderline tumors (P < 0.001). MS was significantly higher in malignant tumors than in benign tumors and in borderline than in benign tumors (P < 0.001, P = 0.013, respectively). THR was significantly lower in malignant tumors than in benign tumors and in borderline than in benign tumors (P < 0.001, P = 0.007, respectively). There was no statistically significant difference between malignant and borderline tumors in MS and THR (P = 0.19, 0.153) or among malignant, borderline, and benign tumors in EA (all P > 0.05).
DCE-MRI is helpful for characterizing complex ovarian tumors; however, semi-quantitative parameters perform poorly when distinguishing malignant from borderline tumors.
本研究旨在探讨动态对比增强磁共振成像（DCE-MRI）在鉴别恶性、交界性和良性卵巢复杂肿瘤中的应用价值。
回顾性分析102例经手术及组织病理学证实的连续卵巢复杂肿瘤（良性15例、交界性16例、恶性71例）的DCE-MRI数据。评估并比较良性、交界性和恶性卵巢肿瘤的时间-信号强度曲线（TIC）类型（I、II和III型）以及三个半定量参数，包括增强幅度（EA）、最大斜率（MS）和上升一半时间（THR）。采用Pearson卡方检验比较恶性与良性、交界性肿瘤之间的TIC类型。使用单因素方差分析或非参数Kruskal-Wallis检验比较EA、MS和THR的平均值。
71例（83%）恶性肿瘤中有59例表现为III型TIC；16例（56%）交界性肿瘤中有9例表现为II型TIC，15例（67%）良性肿瘤中有10例表现为II型TIC，恶性与良性肿瘤之间（P < 0.001）以及恶性与交界性肿瘤之间（P < 0.001）差异有统计学意义。恶性肿瘤的MS显著高于良性肿瘤，交界性肿瘤的MS也显著高于良性肿瘤（分别为P < 0.001，P = 0.013）。恶性肿瘤的THR显著低于良性肿瘤，交界性肿瘤的THR也显著低于良性肿瘤（分别为P < 0.001，P = 0.007）。恶性与交界性肿瘤之间的MS和THR差异无统计学意义（P = 0.19，0.153），恶性、交界性和良性肿瘤之间的EA差异也无统计学意义（均为P > 0.05）。
DCE-MRI有助于卵巢复杂肿瘤特征的描述；然而，在区分恶性与交界性肿瘤时，半定量参数表现不佳。
