3.0T动态增强磁共振对前列腺癌的定量分析研究

Quantitative diagnostic value of DCE-MRI in prostatic cancer

目的:探讨3.0T磁共振动态增强(DCE-MRI)定量分析对前列腺癌的诊断价值,并评价Ktrans与Gleason评分的相关性。方法:回顾性分析40例经病理证实的前列腺疾病患者的病例资料,其中前列腺癌(PC)患者28例,前列腺增生(BPH)患者12例,每例患者均行常规MRI和DCE-MRI检查,通过与病理结果对照,在MRI图像上共选取130个样本,分为前列腺癌区、外周带非癌区和中央腺体非癌区三组,在前列腺定量参数伪彩图上取ROI并测量Ktrans、Ve及Kep值,对三组的各参数值分别行方差分析,并检验PC组Ktrans值与Gleason评分的相关性。结果:前列腺癌区的Ktrans、Ve及Kep值分别为(0.62±0.10)min-1、(0.44±0.12)和(1.45±0.25)min-1,外周带非癌区分别为(0.21±0.06)min-1、(0.29±0.65)和(0.76±0.21)min-1,中央区非癌区分别为(0.32±0.09)min-1、(0.34±0.70)和(0.95±0.26)min-1,Ktrans、Ve及Kep值在各组间差异均有统计学意义(F值分别为234.338、32.593及92.462,P值均<0.05);PC组Ktrans、Ve值在不同Gleason评分组间差异有统计学意义(F值分别为6.354、9.217,P值均<0.05),Kep值在不同Gleason评分组间差异无统计学意义(P值>0.05);前列腺癌区的Ktrans值与Gleason评分呈正相关(r=0.533,P<0.05)。结论:3.0TDCEMRI定量分析研究能为PC的诊断提供客观依据。前列腺癌区的Ktrans值与Gleason评分呈正相关,提示定量参数Ktrans值可用于评估PC的恶性程度。

Objective：To study the diagnostic value of quantitative analysis parameters of DCE-MRI in the diagnosis of prostate cancer and to evaluate the correlation between Kt and Gleason scores. Methods： Forty patients with pathologically proved prostate diseases underwent conventional MRI and DCE-MR examinations. They were divided into three groups ： cancerous loci, noncancerous area in the peripheral zone and central gland. ROIs were drawn on areas of prostate tissue to measure the values of Ktrans, Vo and Kep. The 3 parameters in the different groups were analyzed, and the correlations between K and Gleason scores were studied. Results：The Ktrans ,Ve and Kep valuesof cancerous loci were （0.62±0.10）/min, （0.44 ± 0. 12） and （ 1.45± 0. 25 ）/min, respectively, while, for noncancerous area in the peripheral zone were （0. 21± 0.06）/min, （0.29 ± 0.65 ）, （0.76±0.21）/min, respectively, and for noncancerous area in the central gland were （0.32 ± 0.09）/rain, （0.34±0.70）, （0.95±0.26 ）/min, respectively. The differences between K , Vo and Kep values of the three groups were statistically significant （F= 234. 338,32. 593 and 92. 462, respectively; P〈0.05）. Significant correlation was found between K and Gleason score （r= 0. 533, P〈0.05）. Conclusion： The differences of K , Vo and Kep among the three groups （cancerous foci,noncancerous area in the peripheral zone and central gland） are statistically significant. 3.0T DCE-MRI quantitative analysis plays an important role in the diagnosis of prostate cancer. Positive correlation is found be- tween K and Gleason score. Ktrans can be used for evaluating the degree of malignancy of prostate cancer.