MRI弥散张量成像对前列腺疾病的诊断价值

The diagnosis values of MRI diffusion tensor imaging in prostate disease

目的:初步探讨弥散张量成像(diffusion tensor imaging,DTI)对前列腺癌(prostate carcinoma,PCa)和良性前列腺增生(benign prostate hyperplasia,BPH)的诊断及鉴别诊断价值。方法:分别对22例PCa和31例BPH患者及20名健康志愿者进行前列腺DTI扫描,并通过AW4.2后处理工作站进行数据处理,分析PCa癌灶、BPH增生结节、正常中央带及外周带的各向异性值(fractional anisotropy,FA值)和平均表观弥散系数(apparent diffusion coeffi-cient,ADC值)的变化特点,并绘制DTI参数图及纤维追踪图。结果:PCa、BPH、正常中央带及外周带的FA值依次降低,分别为(0.417±0.096)、(0.247±0.027)、(0.189±0.013)和(0.158±0.032),四者有显著统计学差异(P=0.000)。PCa、BPH、正常中央带及正常外周带的ADC值依次增高,分别为(1.166±0.248)×10-3mm2/s、(1.832±0.476)×10-3mm2/s、(2.027±0.135)×10-3mm2/s和(2.295±0.210)×10-3mm2/s,四者有显著统计学差异(P=0.000)。结论:DTI能够提供前列腺的组织微观结构信息,有助于前列腺疾病的诊断及鉴别诊断。

Aim：To investigate the value of DTI in diagnosis and differential diagnosis of prostate cancer（PCa） and benign prostatic hyperplasia（BPH）.Methods： Twenty-two patients with PCa,31 BPH patients and 20 healthy volunteers were scanned in prostate DTI.All data were transfered to the AW 4.2 workstation for processing.The changes of fractional anisotropy（FA） and average apparent diffusion coefficient（ADC） of PCa foci,BPH nodules,normal central zone and peripheral zone were analyzed by two radiologists,and DTI parametric map and fiber tracking map were drawn.Results： The FA values of PCa,BPH,normal central zone and peripheral zone were decreased in turn,they were 0.417±0.096,0.247±0.027,0.189± 0.013 and 0.158 ±0.032 respectively,and there is statistical difference among the four observation groups（P=0.000）.The ADC values of PCa,BPH,normal central zone and peripheral zone were decreased in turn,they were（1.166±0.248）×10-3 mm2/s,（1.832±0.476）×10-3 mm2/s,（2.027±0.135）×10-3 mm2/s and（2.295±0.210）×10-3 mm2/s,and there was statistical difference among the four observation groups（P=0.000）.Conclusion：DTI can provide microscopic information on prostate tissue,and is good for prostate disease diagnosis and differential diagnosis.