不同感兴趣区选择方法在上皮性卵巢癌动态增强MRI参数中一致性的比较

目的:探讨不同感兴趣区在上皮性卵巢癌动态增强磁共振（DCE-MRI）各半定量参数值中一致性的比较。方法:回顾性分析60例病理证实为上皮性卵巢癌患者治疗前常规MRI和DCE-MRI图像，通过后处理软件测量DCE-MRI半定量参数值，包括达峰时间（TTP）、最大浓度（MAX）、对比浓度-时间曲线下面积（AUC）和最大线性斜率（MS）。两名医师分别在半定量参数AUC伪彩图上采用不规则形、圆形及矩形法勾画ROI，其中测量者1间隔1月后重复测量。采用单因素方差分析（One-Way ANOVA）比较不同ROI勾画方法所得DCE-MR半定量值间的差异，组间及组内一致性采用相关系数（ICC），变异系数（CV）和Bland-Altman散点图评价。结果:三组不同ROI所测各半定量参数值差异均无统计学意义（P>0.05）。采用不规则形ROI所测量的各参数可重复性好，组内和组间ICC分别为（0.975～0.985），（0.961～0.984）；CV分别为（2.73～4.21），（3.48～4.86）。Bland-Altman散点图显示，不规则形法所得测量值一致性高于圆形/矩形法。结论:上皮性卵巢癌采用不同ROI对各半定量参数无显著影响，且均显示较高的一致性。 

Dynamic Contrast-enhanced MRI Parameters Measurements in Epithelial Ovarian Carcinoma:Comparison of ROI on the Reproducibility of the Parameters

Objective: The study aimed to investigate the comparison of different regions of interest (ROI) on reproducibility of semi-quantitative parameters in dynamic contrast-enhanced MRI (DCE-MRI) of epithelial ovarian cancer. Methods: DCE-MRI data of 60 epithelial ovarian cancers, confirmed by surgery and histopathology, were analyzed retrospectively. Four DCE-MRI semi-quantitative parameters, including the peak time (TTP), the maximum concentration (MAX), the area under the concentration time curves (AUC) and the maximal slope (MS), were measured with postprocessing software. The two physicians used the irregular shape, the circular shape and the rectangular method to delineate the ROI on the semi-quantitative AUC pseudo-color image. The data were calculated by two observers independently, observer 1 reevaluated all of the images, which were presented in a different order, one month after the first session. The differences of DCE-MRI semi-quantitative values with different ROI methods, which can be compared in One-Way ANOVA.Intra and interobserver agreement, were evaluated using the intraclass correlation coefficient (ICC), coefficient of variation (CV) and Bland-Altman analysis. Results: There was no significant difference among the three groups (P>0.05). Intra- and interobserver reproducibility were excellent by polygon ROI, The values of ICC in the intraobserver and the interobserver were (0.975~0.985) and (0.961~0.984), respectively; CV were (2.73~4.21) and (3.48~4.86), respectively. The results showed that polygon repeat the measurement of consistency in the range of small, good accuracy. Conclusions: Epithelial ovarian cancer with different ROI had no significant effect on the semiquantitative parameters, and showed a high degree of consistency.