Fan Hua, Wang Ting-Ting, Ren Gang, Fu Hong-Liang, Wu Xiang-Ru, Chu Cai-Ting, Li Wen-Hua
Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China.
Department of Nuclear Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kong Jiang Road, Shanghai 200092, China.
Taiwan J Obstet Gynecol. 2018 Feb;57(1):40-46. doi: 10.1016/j.tjog.2017.12.007.
0BJECTIVE: We compared the diagnostic accuracy of contrast-enhanced computed tomography (CT), fluorine 18-labeled-fludeoxyglucose (F-FDG) positron emission tomography (PET)/CT and conventional magnetic resonance imaging (MRI) without and with diffusion-weighted imaging (DWI) for characterization of tubo-ovarian abscesses (TOAs) that mimic adnexal tumors.
We evaluated (retrospectively) 43 patients who underwent contrast-enhanced CT, PET/CT, conventional MRI without and with DWI, and who were found to have TOAs and complex adnexal tumors. All images were evaluated independently by four radiologists using a two-point grading system. Results of contrast-enhanced CT, PET/CT, MRI without DWI, and MRI with DWI were compared for each patient using receiver operating characteristic curves. Sensitivity, specificity, and positive predictive value (PPV) were calculated and compared using the chi-square test.
Sensitivity of MRI with DWI (95%) was significantly higher than that of contrast-enhanced CT (78.6%), PET/CT (86.7%) and MRI without DWI (87.5%). Specificities of these modalities were not significantly different. The PPV of MRI with DWI (100%) was significantly higher than that of the other three modalities (CT, 72.4%; PET/CT 78.5%; MRI without DWI, 81.5%). Overall accuracy of MRI with DWI was significantly higher than that of the other three modalities (CT, 74.4%; PET/CT, 81.4%; MRI without DWI, 83.7%).
MRI with DWI shows high accuracy for characterization of complex ovarian lesions, and is the most useful method for differentiation of TOAs from ovarian tumors.
目的：我们比较了对比增强计算机断层扫描（CT）、氟-18标记的氟脱氧葡萄糖（F-FDG）正电子发射断层扫描（PET）/CT以及未使用和使用扩散加权成像（DWI）的传统磁共振成像（MRI）对模拟附件肿瘤的输卵管卵巢脓肿（TOA）进行特征性诊断的准确性。
我们（回顾性地）评估了43例接受对比增强CT、PET/CT、未使用和使用DWI的传统MRI检查且被发现患有TOA和复杂附件肿瘤的患者。所有图像由四位放射科医生使用两点分级系统独立评估。使用受试者操作特征曲线对每位患者的对比增强CT、PET/CT、未使用DWI的MRI和使用DWI的MRI结果进行比较。计算敏感性、特异性和阳性预测值（PPV），并使用卡方检验进行比较。
使用DWI的MRI敏感性（95%）显著高于对比增强CT（78.6%）、PET/CT（86.7%）和未使用DWI的MRI（87.5%）。这些检查方法的特异性无显著差异。使用DWI的MRI的PPV（100%）显著高于其他三种检查方法（CT为72.4%；PET/CT为78.5%；未使用DWI的MRI为81.5%）。使用DWI的MRI的总体准确性显著高于其他三种检查方法（CT为74.4%；PET/CT为81.4%；未使用DWI的MRI为83.7%）。
使用DWI的MRI对复杂卵巢病变的特征性诊断具有较高准确性，是区分TOA与卵巢肿瘤最有用的方法。
