多b值DWI在前列腺癌和前列腺增生鉴别诊断中的应用研究

A Study on the Application of Multiple B- value DWI in Differentiation of Prostate Cancer and Benign Prostate Hyperplasia

目的探讨1.5 T MR上多b值弥散加权成像(DWI)定量指标在前列腺癌(PCa)和前列腺增生(PBH)鉴别诊断中的应用价值并寻求合适的诊断阈值。方法行前列腺T2WI、DWI及动态增强扫描并经病理证实的40例患者,按照前列腺6分区法在各区取ROI测量相应部位的表现扩散系数(ADC)值,根据手术病理或穿刺活检的结果,将病变归入相应的分区。对前列腺癌区、增生区所得的各样本参数值进行分析比较。分析各区之间参数有无统计学差异,将ADC数据绘制成ROC曲线,计算曲线下面积和最佳临界值,得出相应的灵敏度、特异度和准确度。结果40例患者240个分区均得到病理证实,前列腺癌区的ADC值为(0.690±0.147)×10-3mm2/s,增生区为(1.420±0.251)×10-3mm2/s,前列腺癌区与增生区ADC值均有显著性差异(P<0.001);当ADC诊断界值取0.935×10-3mm2/s时,诊断前列腺癌的灵敏度、特异度、准确度分别为94.9%、95.8%、98.3%。结论多b值DWI技术可对前列腺癌和前列腺增生进行定量鉴别诊断。

Objectlve To investigate the applying value of the quantitative analysis parameters of multiple b-value diffusion weighted imaging on differentiation of prostate cancer and benign prostate hyperplasia.Metheds MR examinations （T2WI, DWI and DCE-MRI） were performed in 40 patients confirmed by biopsy, ROI were drawn on areas of cancerous foci and prostate hy- perplasia foci to measure the values of ADC. The values of the parameters in different tissue were compared with t-test . Receive operating characteristic （ROC） curve analysis of ADC was used to determine the threshold of malignant, its sensitivity, specificity and accuracy respectively.Results All the 240 sextants from 40 cases were confirmed by biopsies, the ADC values of cancerous foci were （ 0.690±0. 147 ） ×10-3mm2/s, while （ ：1.420±0.25：1 ）×10-3mm2/s for prostate hyperplasia foci.The difference on ADC parameter between cancerous foci, prostate hyperplasia foci were statistically significant （P〈0.001）. The sensitivity, specificity and accuracy for the detection of prostate cancer were 94.9%, 95.8% and 98.3% for ADC values.Ceeclesien Multiple b-value diffusion weighted imaging can make the quantitative analysis on differentiation of prostate cancer and benign prostate hyperplasia.