高b值DWI对前列腺癌和前列腺炎的鉴别诊断价值

Value of high-b-value Diffusion-weighted Imaging in the Differential Diagnosis of Prostate Cancer and Prostatitis

目的探讨高b值DWI对前列腺癌和前列腺炎的鉴别诊断价值。资料与方法 26例经外科手术或穿刺、病理证实的前列腺疾病患者,其中前列腺癌15例,前列腺炎11例,所有患者于手术或穿刺前行MR扩散加权成像,b值选择1000、2000、3000s/mm2,观察对不同b值的扩散加权图像,比较不同b值对前列腺癌及前列腺炎的定性诊断准确率。结果 b值为1000s/mm2时,DWI诊断前列腺癌和前列腺炎的敏感度及特异度分别为66.6%和63.6%;b值为2000s/mm2时,DWI诊断前列腺癌和前列腺炎的敏感度及特异度分别为93.3%和90.9%;b值为3000s/mm2时,DWI诊断前列腺癌和前列腺炎的敏感度及特异度分别为93.3%和100.0%。在b值为1000s/mm2时,DWI诊断前列腺癌和前列腺炎的敏感度及特异度均低于b值为2000、3000s/mm2(P<0.05)。结论选择较高b值,对前列腺癌和前列腺炎的鉴别具有较高的灵敏度和特异度。DWI可作为鉴别前列腺癌和前列腺炎的辅助方法。

Purpose To evaluate the high-b-value diffusion-weighted imaging in differential diagnosis of prostate cancer and prostatitis. Materials and Methods Twenty- six patients with surgically and pathologically confirmed prostate cancer （n-15） and benign prostatitis （n=l 1） were enrolled in this study. Before surgery or biopsy, high-b- value （b=1000, 2000, 3000 s/mm2） sequence scanning were performed in all patients. Different qualitative diagnosis accuracy under three b values were analyzed. Results The diagnostic sensitivity ofb value （b=1000, 2000, 3000 s/mm2） imaging was 66.6%, 93,3% and 93.3%, respectively. While the specificity was 63.6%, 90.9% and 100.0%, respectively. The use of b value （b^2000, 3000 s/mm2） imaging was superior to use of b-value （b^1000 s/ram2） imaging in both sensitivity and specificity （P〈0.05）. Conclusion High-b-value （b=2000, 3000 s/ram2） diffusion-weighted sequence imaging is very useful in differentiating prostate cancers from prostatitis. It has very high sensitivity and accuracy, and can be used as the supplemental methods in prostate cancers diagnosis.