3.0 T MR动态增强成像在前列腺癌诊断中的应用研究

3 T dynamic contrast-enhanced MRI diagnosis of prostate cancer

目的探讨3.0 T MR动态增强成像(DCE-MRI)在前列腺癌诊断中的应用价值。方法收集疑诊前列腺癌者75例,所有患者均行T2WI和DCE-MRI检查。分析比较T2WI和DCE-MRI对前列腺癌诊断敏感性、特异性和准确性的差异,并分析DCE-MRI对前列腺癌的检出率和Gleason评分的相关性。结果前列腺癌患者44例,T2WI和DCE-MRI对前列腺癌诊断的敏感性、特异性和准确性分别为64%和91%、58%和77%、61%和85%。DCE-MRI诊断敏感性和准确性明显高于T2WI(P<0.01),而特异性未见明显高于T2WI(P>0.05)。DCE-MRI对高分化组Gleason评分<7分的前列腺癌检出率明显低于对中低分化组Gleason评分≥7分的前列腺癌(P<0.05)。结论和T2WI相比,3.0 T DCE-MRI能明显提高对前列腺癌的诊断敏感性和准确性。而且,DCE-MRI更容易检出中低分化的前列腺癌。

Objective To evaluate the diagnostic accuracy of 3 T dynamic contrast-enhanced MRI（DCE-MRI） for prostate cancer.Methods 75 patients with clinical suspicion of prostate cancer underwent T2-weighted MR imaging（T2WI） and DCEMRI.The sensitivity,specificity and accuracy of T2 WI and DCE-MRI for diagnosing prostate cancer were determined.The relationship between Gleason score and prostate cancer detection on DCE-MRI was also evaluated.Results Of 75 patients,prostate adenocarcinoma was confirmed histopathologically in 44.The sensitivity and accuracy of DCE-MRI（91%,85%） were significantly（P〈0.01） higher than those of T2WI（64%,61%）.The specificity of DCE-MRI（77%） was not significantly（P〉0.05） higher than that of T2WI（58%）.The detection rate for Gleason 4-6 cancers was significantly lower than that for Gleason 7-9 cancers（P〈0.05）.Conclusion 3 T DCE-MRI is superior to T2 WI in prostate cancer detection and can detect more aggressive tumors.