3.0T MRI联合扩散加权成像对前列腺癌的定性诊断价值

Clinical value of diffusion-weighted 3.0T magnetic resonance imaging in prostate cancer

目的在3.0T MRI检查仪上分析前列腺癌的表观扩散系数的变化,以病理结果作对照,探讨常规MRI、DWI两种成像方法及其联合应用对前列腺癌进行定性诊断的价值。方法收集28例前列腺癌(PCa)及20例前列腺增生(BPH)患者资料;在DWI上观察病灶的信号并进行ADC值测量,通过受试者操作特性曲线(ROC)评估ADC值对PCa的诊断效能,比较常规MRI单独应用及和ADC值二者联合应用对前列腺癌的诊断价值。结果 PCa平均ADC值为(0.78±0.025)×10-3,BPH平均ADC值为(1.59±0.045)×10-3。PCa与BPH的ADC值存在明显差异(P<0.05),根据ADC值诊断PCa的最佳诊断域值为1.182×10-3,此诊断域值敏感度为85.1%,特异性为96.4%。诊断效能:常规MRI诊断PCa的敏感度为82.14%,特异性为80.00%,准确度为81.25%。MRI+DWI诊断PCa的敏感度达92.85%,特异性为85%,准确度为89.58%。结论联合应用常规MRI和DWI的诊断效能优于单独应用常规MRI,3.0T MRI结合DWI有助于前列腺癌的早期诊断及鉴别诊断。

Objective To explore the magnetic resonance imaging （MRI） and magnetic resonance diffusion-weighted imaging （DWI） methods, and their joint application to the qualitative diagnosis of prostate cancer （PCa）, and analyze of DWI and apparent diffusion coefficient changes with 3.0T MRI and pathological findings. Methods Total of 28 PCa and 20 cases of BPH patients with pathologically confirmed information was collected from March 2011 to January 2012. Observed the signal of the lesion and measured ADC values in the MR workstation. Application SPSS13.0 statistical software for statistical analysis and ADC values of PCa diagnostic performance by receiver operating characteristic （ROC） curve, and to determine the best diagnostic threshold with diagnostic imaging results and pathological comparative analysis, comparing the difference of 3.0T MRI and ADC value alone and their combination. Results The mean ADC value of PCa was 0.78 ±0. 025× 10^-3 （P 〈 0.05） , the mean ADC value of BPH was 1.59 ± 0. 045 × 10^-3 （P〈0.05）. PCa and BPH ADC values were significantly different, According to ROC curve analysis, the best diagnostic domain of the ADC value was 1. 182 × 10^-3, this diagnostic threshold sensitivity was 85.1% and specificity was 96.4%. MRI diagnosis of PCa sensitivity was 82.14%, specificity was 80%, and accuracy was 81, 25%. MRI ＋ DWI diagnosis of PCa sensitivity was 92. 85%, specificity was 85%）, and accuracy was 89. 58%. Conclusion Combined MRS and DWI diagnostic performance superior to the separate application of MRI, The combination of MRI and DWI contribute to early prostate cancer diagnosis and differential diagnosis.