联合应用磁共振灌注成像和弥散成像对前列腺癌的诊断价值研究

Diagnostic value of combining diffusion and perfusion MR imaging in the prostate cancer

目的:探讨联合应用磁共振灌注加权成像(PWI)和弥散加权成像(DWI)对前列腺癌的诊断和鉴别诊断价值。方法:收集行PWI和DWI检查的前列腺癌(PCa)38例、良性前列腺增生(BPH)33例及慢性前列腺炎11例,利用灌注参数相对负性强化积分(rNEI)、弥散参数表观弥散系数(ADC)及综合应用两者进行诊断,并与病理诊断相比较,分别通过ROC曲线分析比较,并计算各诊断方法的敏感度、特异度、准确度、阳性预测值及阴性预测值等指标。结果:应用PWI、DWI及联合应用两者诊断前列腺癌的敏感度、特异度、准确度、阳性预测值及阴性预测值分别是79.2%、89.1%、86.2%、75.0%、91.2%;84.0%、92.5%、90.0%、82.3%、93.3%和90.1%、94.8%、93.7%、92.9%、94.0%。结论:PWI及DWI2种方法均可以有效诊断前列腺癌;两种成像方法综合应用可提高诊断的准确度。

Objective： To evaluate the diagnosis and differential diagnosis value of perfusion MR imaging （PWI） ＆ diffusion MR imaging （DWI） for prostate cancer （PCa）. Methods： 38 cases of PCa, 33 cases of BPH and 11 cases of chronic prostatitis were recruited, who underwent imaging of the prostate with a combination of PWI and DWI. Sensitivity, specificity, accuracy, positive predictive value （PPV） and negative predictive value （NPV） were estimated for PWI and DWI by comparethe difference of related parameters （including rNEI and ADC） among three groups. The receiver operating characteristic （ROC） curve analysis were also taken for the comparison. Results： The sensitivity, specificity, accuracy, PPV, and NPV of PWI were 79.2%, 89.1%, 86.2%, 75.0%, and 91.2%, respectively. The sensitivity, specificity, accuracy, PPV, and NPV of DWI were 84.0%, 92.5%, 90.0%, 82.3%, and 93.3%, respectively. The sensitivity, specificity, accuracy, PPV, and NPV of combining PWI and DWI were 90.1%, 94.8%, 93.7%, 92.9%, and 94.0%, respectively. Conclusion： Prostate cancer could be effectively diagnosed with PWI and DWI, respectively. The combination of the two techniques could improve the accuracy in the detection of prostate cancer.