Value of DWI combined with conventional MRI in the differential diagnosis between fibrothecomas and malignant pelvic solid tumors / 实用放射学杂志

ABSTRACT

Objective To evaluate the value of diffusion weighted imaging(DWI)combined with conventional MRI in the differential diagnosis between fibrothecomas and malignant pelvic solid tumors.Methods Conventional MRI and DWI of 23 fibrothecomas in 22 patients and 26 malignant pelvic solid tumors were analyzed retrospectively.ADC values between the two groups were compared by the Student's t-test.The receiver operating characteristic(ROC)curve was applied to determin the ability of the lowest and mean ADC values to differentiate thecomas/fibrothecomas from malignant pelvic solid masses.Group differences in shape,border,T2WI signal intensity,DWI signal intensity,enhancement degree and CA125 levels were compared with χ2test.Results In the fibrothecoma group,hypo-,iso-,hyper-and mixed intensity on T2WI accounted for 52.2%,17.4%,8.7% and 21.7%,respectively.In the malignant pelvic solid tumor group,all masses showed hyperintensity on T2WI.The mean ADC value of fibrothecomas[(1.24±0.30)×10-3mm2/s]was significantly higher than that of malignant pelvic solid tumors[(0.89 ± 0.22)×10-3mm2/s](t=4.571,P<0.001).In the ROC curve analysis,when the lowest ADC value of 1.01×10-3mm2/s was used as the cut-off value,sensitivity,specificity and accuracy were 78.3%,80.2% and 79.6%,respectively.There were significantly statistical differences between groups in shape,border,T2WI signal intensity,DWI signal intensity,enhancement degree and CA125 levels.Conclusion The combination of DWI and conventional M RI is of great value in the differential diagnosis between fibrothecomas and malignant pelvic solid tumors,which could provide references for gynecologists to make better choices of clinical treatment strategies.