摘要
目的探讨扩散加权成像(diffusion-weighted imaging,DWI)联合T2 mapping序列鉴别前列腺癌(prostate cancer,PCa)与前列腺增生(benign prostatic hyperplasia,BPH)的价值。材料与方法回顾性分析本院行3.0 T MRI检查且经病理证实的56例PCa患者及40例BPH患者资料。扫描序列包括T1WI、T2WI、DWI及T2 mapping序列。两名观察者分别测量两组病灶的表观扩散系数(apparent diffusion coefficient,ADC)值及T2值。采用组内相关系数(intra-class correlation coefficient,ICC)评估两名观察者测得参数值的一致性。采用独立样本t检验或Mann-Whitney U检验分析两组病例间ADC值及T2值的差异。Logistic回归用于分析差异具有统计学意义的参数及其与基线资料联合的诊断模型。采用受试者工作特征(receiver operating characteristic,ROC)曲线评估有差异参数及联合模型的诊断效能。采用DeLong检验比较ROC曲线下面积差异。采用Spearman相关系数分析ADC值与T2值相关性。结果两名观察者测量值一致性好(ICC>0.75)。PCa组的ADC值及T2值分别低于BPH组,差异具有统计学意义(P<0.01)。ADC值、T2值、ADC-T2及ADC-T2-年龄-总前列腺特异性抗原(total prostate specific antigen,TPSA)联合鉴别PCa与BPH的AUC值分别为0.843、0.830、0.896及0.927。DeLong检验显示ADC值与ADC-T2联合,ADC值、T2值、ADC-T2模型与ADC-T2-年龄-TPSA联合模型的ROC差异存在统计学意义(P<0.05)。ADC值与T2值呈正相关(r=0.331,P<0.01)。结论DWI及T2 mapping序列在鉴别PCa与BPH方面具有较好的价值,并且两序列联合临床指标时诊断效能提升,可为临床无创诊断PCa及BPH提供很好的指导意义。
Objective:The efficacy of combining diffusion weighted imaging(DWI)with T2 mapping sequences in differentiating prostate cancer(PCa)and benign prostatic hyperplasia(BPH).Materials and Methods:We conducted a retrospective analysis of data from 56 patients diagnosed with PCa and 40 patients with BPH,who underwent 3.0 T MRI examinations at our hospital and received pathological confirmation.The scanning sequences included T1WI,T2WI,DWI and T2 mapping sequences.Two observers independently measured the apparent diffusion coefficient(ADC)values and T2 values of the lesions in both groups.The intra-class correlation coefficient(ICC)was used to assess inter-observer agreement.Differences in ADC values and T2 values between the two groups were analyzed using independent samples t-test or Mann-Whitney U test.Logistic regression was employed to create diagnostic models using discrepant parameters and baseline information.ROC curves were constructed to evaluate the diagnostic efficacy of the differentiated parameters and the joint model.The DeLong test was used to compare differences in the area under the ROC curve(AUC).Spearman's correlation coefficient was calculated to assess the correlation between ADC values and T2 values.Results:Excellent agreement was observed between the measurements of the two observers(ICC>0.75).The PCa group exhibited significantly lower ADC and T2 values compared to the BPH group(P<0.01).The AUC values for ADC,T2,ADC-T2 joint model,and ADC-T2-age-total prostate specific antigen(TPSA)joint model in distinguishing PCa from BPH were 0.843,0.830,0.896 and 0.927.DeLong's test showed statistically significant differences in the ROC curves for ADC and ADC-T2 jointly and for ADC,T2,ADC-T2 model and ADC-T2-age-TPSA joint model(P<0.05).ADC values were positively correlated with T2 values(r=0.331,P<0.01).Conclusions:DWI and T2 mapping hold substantial value in differentiating between PCa and BPH.The diagnostic efficacy improves when combining these sequences with clinical indicators such as age and TPSA.This combined imaging approach offers promising non-invasive diagnostic guidance for PCa and BPH in clinical settings.
作者
李茜玮
陈丽华
王楠
林良杰
刘爱连
LI Xiwei;CHEN Lihua;WANG Nan;LIN Liangjie;LIU Ailian(Department of Radiology,the First Hospital of Dalian Medical University,Dalian 116011,China;Dalian Medical Imaging Artificial Intelligence Technology Research Center,Dalian 116011,China;Philips(China)Investment Co.,LTD,Beijing Branch,Beijing 100016,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2024年第2期97-102,共6页
Chinese Journal of Magnetic Resonance Imaging
关键词
前列腺癌
前列腺增生
扩散加权成像
T2
mapping成像
磁共振成像
鉴别诊断
prostate cancer
prostatic hyperplasia
diffusion-weighted imaging
T2 mapping imaging
magnetic resonance imaging
differential diagnosis