3.0 T MR动态增强扫描定量分析诊断前列腺癌的价值

Prostate cancer： diagnostic value of quantitative analysis by dynamic contrast-enhanced MR at 3.0 T

目的 探讨3.0 T MR动态增强扫描（DCE-MRI）定量分析诊断前列腺癌,尤其是中央腺体癌的价值.方法 回顾性分析行前列腺DCE-MRI检查,并经前列腺根治术后病理证实的26例患者资料.将前列腺根治标本制成前列腺病理大切片,根据病理标本的分区定位标准及结果,在DCE-MRI定量参数图上分别测量前列腺相应部位的转运常数（Ktrans）、血管外细胞外间隙体积百分数（Ve）及速率常数（kep）.对中央腺体癌区、中央腺体非癌区、外周带癌区及外周带非癌区的各定量参数值分别进行Kruskal-Wallis H检验,各参数值的组内两两比较采用Mann-Whitney U检验.结果 26例前列腺癌共获得可评估前列腺分区468个,其中中央腺体癌区115个、中央腺体非癌区142个、外周带癌区68个、外周带非癌区143个.前列腺癌呈明显多灶性分布.中央腺体癌区的Ktrans、kep、Ve值分别为（1.04 ±0.26）/min、（1.43±0.46）/min和0.76 ±0.12,中央腺体非癌区分别为（0.82±0.19）/min、（1.12±0.26）/min、0.75±0.14,外周带癌区分别为（0.95±0.31）/min、（1.31±0.51）/min和0.76±0.13,外周带非癌区分别为（0.32±0.07）/min、（0.52±0.13）/min和0.64±0.14,各参数值组间差异均有统计学意义（x2值分别为316.008、297.985、63.681,P值均＜0.01）.Ktrans、Kep值组内两两比较,前列腺癌区均高于非癌区（P＜0.05）.结论 DCE-MRI定量参数有助于前列腺癌灶,包括中央腺体癌灶的诊断.

Objective To investigate the diagnostic value of the quantitative analysis parameters of dynamic contrast-enhanced MRI （DCE-MRI） for prostate cancer.Methods MR examination were performed in 26 patients and correlations were made with surgical pathology following radical prostatectomy.According to the localization of pathologic specimens,ROI were drawn on areas of cancerous regions,noncancerous regions in peripheral zone and central gland to measure the values of Ktrans,kep and Ve.The values of the three parameters in different tissue were compared with Kruskal-Wallis H and Mann-Whitney U.Results Twenty six patients had prostate cancer confirmed by pathology.Data from 468 assessable regions of prostate were acquired,including 115 cancerous regions and 142 noncancerous regions in central gland,68 cancerous regions and 143 noncancerous regions in peripheral zone.Prostate cancer showed a multifocal distribution.The K,kep and Ve values were （1.04 ± 0.26）/min,（1.43 ± 0.46）/min,（0.76 ±0.12） respectively for cancerous regions in central gland,and （0.82 ±0.19）/min,（1.12 ±0.26）/min,（0.75 ± 0.14） respectively for noncancerous regions in central gland,（0.95 ±0.31）/min,（1.31 ±0.51）/min,（0.76 ± 0.13） respectively for cancerous regions in peripheral zone and （0.32 ± 0.07）/min,（0.52 ± 0.13）/min,（0.64 ± 0.14） respectively for noncancerous regions in peripheral zone.The differences among the three parameters were statistically significant （x2 =316.008,297.985,63.681,P 〈0.01）.The Ktrans,kep values of cancerous regions were significantly higher than the corresponding values of noncancerous regions,respectively.Conclusion Quantitative analysis parameters of DCE-MRI contribute to the diagnosis of prostate cancer,including cancer located in central gland.