Denewar Fatmaelzahraa Abdelfattah, Takeuchi Mitsuru, Urano Misugi, Kamishima Yuki, Kawai Tatsuya, Takahashi Naoki, Takeuchi Moe, Kobayashi Susumu, Honda Junichi, Shibamoto Yuta
Department of Radiology, Nagoya City University Graduate School of Medical Sciences and Medical School, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya City, Aichi 467-8601, Japan.
Nagoya City West Medical Center, 1-1-1 Hirade-cho, Kita-ku, Nagoya City, Aichi 462-8508, Japan.
Eur J Radiol. 2017 Jun;91:116-123. doi: 10.1016/j.ejrad.2017.04.001. Epub 2017 Apr 6.
To assess the value of contrast-enhanced MRI, apparent diffusion coefficient (ADC) measurement, and CA-125 measurement for differentiating borderline ovarian tumors (BOTs) from stage I malignant epithelial ovarian tumors (MEOTs).
This retrospective study included 43 patients with BOTs and 43 patients with stage I MEOTs who underwent contrast-enhanced MRI with DWI and CA-125 analysis. Two radiologists evaluated the MRI findings in consensus. Univariate and multivariate analyses were performed to detect the best predictor variables for MEOTs.
Mixed cystic/solid and predominantly solid appearances, as well as thickened irregular septa, were more frequent in MEOTs. A papillary architecture and internal branching (PA&IB) pattern was more frequent in BOTs. MEOTs had thicker walls and septa, larger solid components, and higher CA-125 values. The mean ADC value of solid components (ADC) and minimum ADC value of whole lesions (ADC) were lower in MEOTs. Multivariate analysis revealed that ADC and maximum diameter of the solid components were independent indicators of MEOTs with an AUC, sensitivity, and specificity of 0.86, 81%, and 84%, respectively.
ADC and maximum diameter of solid components were useful for differentiating BOTs from MEOTs.
评估对比增强磁共振成像（MRI）、表观扩散系数（ADC）测量及糖类抗原125（CA-125）测量在鉴别卵巢交界性肿瘤（BOT）与Ⅰ期恶性上皮性卵巢肿瘤（MEOT）中的价值。
本回顾性研究纳入了43例BOT患者和43例Ⅰ期MEOT患者，这些患者均接受了同时进行扩散加权成像（DWI）的对比增强MRI检查及CA-125分析。两名放射科医生共同评估MRI表现。进行单因素和多因素分析以检测MEOT的最佳预测变量。
MEOT中混合性囊实性和以实性为主的表现以及不规则增厚的分隔更为常见。BOT中乳头状结构和内部分支（PA&IB）模式更为常见。MEOT的壁和分隔更厚，实性成分更大，CA-125值更高。MEOT中实性成分的平均ADC值（ADC）和整个病变的最小ADC值（ADC）更低。多因素分析显示，ADC和实性成分的最大直径是MEOT的独立指标，曲线下面积（AUC）、敏感性和特异性分别为0.86、81%和84%。
ADC和实性成分的最大直径有助于鉴别BOT与MEOT。
