表观扩散系数值定量分析诊断前列腺癌与前列腺增生的价值探讨

Value of quantitative analysis of apparent diffusion coefficient in diagnosing prostate cancer and benign prostatic hyperplasia

目的探讨磁共振表观扩散系数(apparent diffusion coefficient,ADC)值定量分析诊断前列腺癌(prostate cancer,PCa)与前列腺增生(benign prostatic hyperplasia,BPH)的价值。方法回顾性分析本院2016年1月至2019年1月收治的153例PCa及BPH患者的临床资料,按照疾病类型分为PCa组(A组,n=65)和BPH组(B组,n=88)。根据病变发生位置将A组分为A1组(PCa发生于周围带,n=31)和A2组(PCa发生于移行带,n=34);将B分为B1组(PH发生于周围带,n=9)和B2组(BPH发生于移行带,n=79)。4组患者均于治疗前行磁共振常规序列扫描及弥散加权成像。比较4组患者前列腺病灶处ADC值。结果 A1组与A2组、B1组与B2组ADC值比较差异无统计学意义,A组与B组、A1组与B1组、A2组与B2组ADC值比较差异有统计学意义(P<0.05)。利用ROC曲线分析,截断值为0.848×10^-3mm^2/s时,诊断PCa与BPH敏感度为95.4%,特异度为93.2%。结论 PCa与BPH的ADC值比较有明显差异,ADC值为0.848×10^-3mm^2/s时可鉴别PCa与BPH。

Objective To explore the value of quantitative analysis of nuclear magnetic resonance imaging apparent diffusion coefficient(ADC)in the diagnosis of prostate cancer(PCa)and benign prostatic hyperplasia(BPH).Methods A retrospective collection of 153 patients with PCa and BPH in our hospital from January 2016 to January 2019 were divided into PCa group(group A,n=65)and BPH group(group B,n=88).According to the location of lesions,group A was divided into group A1(PCa occurring in peripheral zone of the prostate,n=31)and group A2(PCa occurring in transition zone,n=34).group B was divided into group B1(BPH occurring in peripheral zone of the prostate,n=9)and group B2(BPH occurring in transition zone,n=79).All the patients in the 4 groups underwent MRI routine sequence scan and diffusion-weighted imaging before treatment.The ADC values of prostate lesions of the 4 groups of patients were compared.Results There was no significant difference in ADC values between group A1 and group A2,group B1 and group B2.However,there was significant difference in ADC values between group A and group B,group A1 and group B1,as well as group A2 and group B2(P<0.05).With the analysis of the ROC curve,the sensitivity of PCa and BPH was 95.4%,and the specificity was 93.2%when the cut-off level was 0.848×10^-3 mm^2/s.Conclusion There was significant difference in the ADC value between PCa and BPH.When the apparent diffusion coefficient value was 0.848×10^-3 mm^2/s,it had certain value in differentiating the diagnosis of PCa and BPH.