Song Xiao-Li, Wang Lifang, Ren Honghong, Wei Rong, Ren Jia-Liang, Niu Jinliang
The Radiology Department, Shanxi Medical University Second Affiliated Hospital, Taiyuan, Shanxi, China.
Pathology Department, Shanxi Medical University Second Affiliated Hospital, Taiyuan, Shanxi, China.
J Magn Reson Imaging. 2020 Mar;51(3):928-935. doi: 10.1002/jmri.26885. Epub 2019 Aug 1.
The differentiation of borderline from malignant ovarian epithelial tumors (OETs) is difficult based on morphologic characteristics. Diffusion and perfusion information from intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) might be useful for this distinction.
To investigate the potential of IVIM-DWI in discriminating borderline from malignant OETs by correlating with cell proliferation and microvessel density (MVD).
Prospective.
Sixty-six patients with OETs (22 borderline, BOETs; 44 malignant, MOETs) underwent IVIM-DWI before surgery.
3.0T IVIM-DWI sequence with 12 b-values (0-1000 sec/mm ).
Apparent diffusion coefficient (ADC) and IVIM-DWI parameters (diffusion coefficient [D], microvascular volume fraction [f], and pseudodiffusion coefficient [D*]) were measured. Cell proliferation and MVD was determined by immunohistochemical staining of Ki-67 and CD-31, respectively.
Mann-Whitney U-test; two-sample t-test; intraclass correlation coefficient; Bland-Altman analysis; receiver operating characteristics (ROC) curves; and Spearman correlation.
ADC and D in BOETs was significantly higher than those in MOETs (P < 0.001), while f in BOETs was significantly lower than those in MOETs (P < 0.001). No significant difference was found in D* between borderline and malignancies (P = 0.324). In the differential diagnosis of borderline from malignant OETs; D demonstrated the highest area under the curve (AUC) of 0.951, while ADC and f had a lower AUC of 0.921 and 0.847, respectively. The ADC and D was negatively correlated with cell proliferation (r = -0.682, r = -0.694, respectively, P < 0.001), while f was positively correlated with MVD of the OETs (r = 0.558, P < 0.001).
IVIM-DWI may be a useful tool for differentiating BOETs from MOETs. D and f could be image biomarkers to reflect histopathological characteristics of cell proliferation and MVD in OETs.
1 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:928-935.
基于形态学特征，很难区分卵巢交界性上皮性肿瘤（OETs）和恶性卵巢上皮性肿瘤。体素内不相干运动（IVIM）扩散加权成像（DWI）的扩散和灌注信息可能有助于这种区分。
通过与细胞增殖和微血管密度（MVD）相关联，研究IVIM-DWI在鉴别卵巢交界性上皮性肿瘤和恶性卵巢上皮性肿瘤中的潜力。
前瞻性研究。
66例卵巢上皮性肿瘤患者（22例交界性，BOETs；44例恶性，MOETs）在手术前接受了IVIM-DWI检查。
3.0T的IVIM-DWI序列，具有12个b值（0 - 1000秒/平方毫米）。
测量表观扩散系数（ADC）和IVIM-DWI参数（扩散系数[D]、微血管容积分数[f]和伪扩散系数[D*]）。分别通过Ki-67和CD-31的免疫组织化学染色测定细胞增殖和MVD。
曼-惠特尼U检验；两样本t检验；组内相关系数；布兰德-奥特曼分析；受试者操作特征（ROC）曲线；以及斯皮尔曼相关性分析。
BOETs中的ADC和D显著高于MOETs（P < 0.001），而BOETs中的f显著低于MOETs（P < 0.001）。交界性肿瘤和恶性肿瘤之间的D*未发现显著差异（P = 0.324）。在鉴别卵巢交界性上皮性肿瘤和恶性卵巢上皮性肿瘤时；D的曲线下面积（AUC）最高，为0.951，而ADC和f的AUC较低，分别为0.921和0.847。ADC和D与细胞增殖呈负相关（分别为r = -0.682，r = -0.694，P < 0.001），而f与卵巢上皮性肿瘤的MVD呈正相关（r = 0.558，P < 0.001）。
IVIM-DWI可能是区分BOETs和MOETs的有用工具。D和f可作为反映卵巢上皮性肿瘤细胞增殖和MVD组织病理学特征的影像生物标志物。
1 技术效能阶段：2 《磁共振成像杂志》2020年；51:928 - 935。
