Singla Veenu, Dawadi Kapil, Singh Tulika, Prabhakar Nidhi, Srinivasan Radhika, Suri Vanita, Khandelwal Niranjan
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education Research (PGIMER), Chandigarh, India.
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education Research (PGIMER), Chandigarh, India.
Curr Probl Diagn Radiol. 2021 Jan-Feb;50(1):34-40. doi: 10.1067/j.cpradiol.2019.07.008. Epub 2019 Jul 12.
To assess the role of diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging in the categorization of complex ovarian masses into benign and malignant.
This prospective study was done on 33 complex ovarian masses. T1 and T2-weighted sequences, diffusion-weighted imaging, apparent diffusion coefficient, and dynamic contrast-enhanced magnetic resonance imaging were performed on 1.5 T MRI. Time-intensity curves, tissue signal intensity on unenhanced T1 images (SI), maximum absolute contrast enhancement (SI), time to reach SI (T), maximum relative SI (SI = [SI - SI]/SI ×100), maximum Slope (Slope = SI/T ×100), and wash in rate (WIR = [SI - SI]/T) were calculated. Histopathological diagnosis was taken as gold standard.
A total of 20/33 masses were benign, 2/33 were borderline tumors, and 11/33 were malignant. Diffusion restriction was seen in all malignant masses and 13/20 benign masses. The mean apparent diffusion coefficient values showed a significant difference between malignant and benign, with 81.8% sensitivity and 63.6% specificity. Type III curve showed 100% specificity for malignant lesions. T and Slope were useful in differentiating benign and malignant masses; with T cut-off at 73.5 seconds having a high specificity (81.8%) and Slope cut-off at 0.83%/s having high sensitivity (91%) and negative predictive value (94.4%).
Multiparametric MRI confers high diagnostic accuracy in stratifying complex ovarian masses.
评估弥散加权成像和动态对比增强磁共振成像在将复杂卵巢肿块区分为良性和恶性中的作用。
对33例复杂卵巢肿块进行了这项前瞻性研究。在1.5T磁共振成像上进行了T1加权和T2加权序列、弥散加权成像、表观扩散系数及动态对比增强磁共振成像检查。计算了时间-强度曲线、未增强T1图像上的组织信号强度（SI）、最大绝对对比增强（SI）、达到SI的时间（T）、最大相对SI（SI = [SI - SI]/SI×100）、最大斜率（斜率 = SI/T×100）及流入率（WIR = [SI - SI]/T）。组织病理学诊断被视为金标准。
33个肿块中，20个为良性，2个为交界性肿瘤，11个为恶性。所有恶性肿块及其中20个良性肿块中的13个可见弥散受限。恶性和良性肿块的平均表观扩散系数值显示出显著差异，敏感性为81.8%，特异性为63.6%。III型曲线对恶性病变的特异性为100%。T和斜率有助于鉴别良性和恶性肿块；T截止值为73.5秒时具有较高特异性（81.8%），斜率截止值为0.83%/秒时具有较高敏感性（91%）和阴性预测值（94.4%）。
多参数磁共振成像在对复杂卵巢肿块进行分层时具有较高的诊断准确性。
