Objective To explore the differential value of magnetic resonance diffusion weighted imaging (MRI-DWI) combined with carbohydrate antigen 125 (CA125) in differential diagnosis of borderline ovarian tumors and epithelial ovarian cancer.
Methods The clinical data of 106 patients with suspected borderline ovarian tumor or epithelial ovarian cancer were analyzed retrospectively. All patients were examined with MRI-DWI, and CA125 level was detected. According to the results of pathological examination, they were divided into borderline ovarian tumors group (59 cases) and epithelial ovarian cancer group (47 cases). MRI-DWI and CA125 levels were compared between the two groups. Receiver operating characteristic (ROC) curve was drawn to analyze the identification efficiency of MRI-DWI and CA125 by MRI-DWI and CA125 alone or their combination for borderline ovarian tumors and epithelial ovarian cancer.
Results The proportion of DWI high signal in the borderline ovarian tumors group was 54.24%, which was higher than 34.04% in the epithelial ovarian cancer group, and the DWI signal intensity was (142.58±16.71), which was higher than that of (126.35±12.20) in the epithelial ovarian cancer group (P < 0.05). Apparent dispersion coefficient (ADC) at different b values of 150, 500, 800 and 1 000×10-3 mm2/s in the borderline ovarian tumors group were (2.05±0.39)×10-3 mm2/s, (1.85±0.35)×10-3 mm2/s, (1.75±0.42)×10-3 mm2/s, (1.61±0.32)×10-3 mm2/s, which were higher than those of (1.24±0.31)×10-3 mm2/s, (1.03±0.22)×10-3 mm2/s, (0.92±0.18)×10-3 mm2/s, (0.86±0.17)×10-3 mm2/s (P < 0.05). R values at b values of 800 and 1 000 s/mm2 were (1.58±0.23), (2.15±0.33) respectively, which were higher than (1.20±0.21), (1.52±0.24) in the epithelial ovarian cancer group (P < 0.05). The CA125 level in the borderline ovarian tumors group was (18.12±3.14) U/mL, which was lower than that of (81.50±12.43) U/mL in the epithelial ovarian cancer group (P < 0.05). The cut-off values of ADC with b values of 150, 500, 800 and 1 000 s/mm2 were 1.71×10-3, 1.42×10-3, 1.31×10-3, 1.15×10-3 mm2/s for borderline ovarian cancer and epithelial ovarian cancer, respectively. The cut-off values of ADC with b values 800 and 1 000 s/mm2 were 1.42 and 1.71 for borderline ovarian cancer and epithelial ovarian cancer, respectively. The sensitivity and area under curve (AUC) of MRI-DWI combined with CA125 were 100.00% and 0.907 respectively, which were higher than those of MRI-DWI or CA125 alone.
Conclusion The proportion of high signal, signal intensity, ADC value at different b values, R value at b values of 800 and 1 000 s/mm2 and CA125 level in ovarian borderline tumors are all higher than those in epithelial ovarian cancer, and the value of MRI-DWI combined with CA125 in distinguishing them is ideal.
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