3.0T弥散加权成像对前列腺包膜外扩散的应用价值

Application of Diffusion-Weighted Imaging at 3.0T for Extracapsular Extension in Patients With Prostate Cancer

目的回顾性分析T2WI结合DWI预测评估前列腺癌患者包膜外扩散,同时比较有或无包膜外扩散前列腺癌ADC值。方法76例前列腺癌患者在前列腺切除术前执行3.0T磁共振检查。由2名经验丰富放射医师分析T2WI和T2WI结合DWI图像,评估外周叶包膜外扩散情况,对有或无包膜外扩散进行ADC值,比较2患者结果。结果共研究456区,其中74个区有包膜外扩散情况,T2WI和T2WI结合DWI特异性和敏感性分别为94.5%、91.7%,优于T2EWI单独检查(分别为87.2%、81.2%),p<0.001。采用ROC分析显示T2WI结合DWI曲线下面积(Az=0.900)明显大于T2WI曲线下面积(Az=0.828),p<0.001。包膜外扩散ADC值明显低于无包膜外扩散ADC值(p<0.001)。结论 T2WI结合DWI图像能够提高预测前列腺癌患者包膜外扩散情况,同时ADC值在评估有或无包膜外扩散具有重要意义。

Objective To retrospectively investigate combine diffusion-weighted imaging （DWI） and T2-weighted imaging for the prediction of extracapsular extension （ECE） in patients with prostate cancer, as well as to compare apparent diffusion coefficients （ADCs） between patients with and without ECE. Methods Seventy-six patients underwent 3T magnetic resonance imaging （MRI） before prostatectomy. Two experienced radiologists analyzed T2-weighted images alone and in combination with DWI in consensus and rated the likelihood of ECE. Tumor ADC values were measured, and the results were compared between patients with and without ECE. Results Of the 456 sectors studied, 74 （16%） were positive for ECE in 31 patients. the specificity and accuracy of combined T2-weighted imaging and DWI were 94.5% and 91.7%, respectively, superior to T2-weighted imaging alone （87.2%and 81.2%, respectively） （p〈0.001）. On receiver operating characteristic analysis, the area under the curve （Az） of combined T2-weighted imaging and DWI （Az=0.900） was significantly greater than that of T2-weighted imaging alone （Az=0.828） （p〈0.001）. The mean tumor ADC values were significantly lower in patients with ECE than patients without ECE （p〈0.001）. Conclusion DWI in addition to T2-weighted imaging improves the ability to predict ECE in patients with prostate cancer. Furthermore, tumor ADC values in patients with and without ECE are significance.