DCE-MRI半定量参数及定量参数在前列腺癌诊断的综合应用研究

Study of Comprehensive Application of Semi-quantitative and Quantitative Parameters of DCE-MRI in Diagnosis of Prostate Cancer

目的探讨动态增强磁共振(DCEMRI)的半定量与定量参数在前列腺癌诊断中的应用价值。方法搜集我院行前列腺DCE-MRI及穿刺病理活检的前列腺癌(PCa)及良性前列腺增生(BPH)各30例;DCE-MRI图像后处理绘制感兴趣区(ROI)并测量半定量参数,包括时间信号曲线(TIC)类型、达峰时间(TTP)、强化峰值(SImax)、早期强化率等(SI1'/SImax),以及定量参数包括Ktrans、Kep、Ve,并进行统计学分析。结果 PCa组与BPH组TIC曲线类型有显著差异:PCa组中III型曲线超过一半;BPH组中I型曲线占2/3。半定量参数TTP、SImax、SI1'/SImax在PCa组分别为(115.3±32.1)s、(2.73±0.62)mmol/L、0.79±0.21;在BPH组分别为(271.6±29.2)s、(2.25±0.54)mmol/L、0.53±0.30。其中TTP、SI1'/SImax差异具有统计学意义。定量参数Kt r a n s、Kep、Ve在PCa组分别为(0.28±0.19)/min、(0.42±0.29)/min、0.61±0.28;在BPH组分别为(0.17±0.26)/min、(0.34±0.24)/min、0.55±0.31。其中Ktrans、Kep值差异具有统计学意义。在表现为II型TIC曲线的PCa病例与BPH病例之间比较各定量参数,其中Ktrans值差异仍有统计学意义。结论 DCE-MRI对前列腺癌与良性前列腺增生的鉴别诊断提供了重要信息,以I型曲线诊断BPH及III型曲线诊断PCa均有较高准确率,结合定量参数Ktrans、Kep值,对PCa诊断有进一步价值。

Objective To study the comprehensive application of semi-quantitative and quantitative parameters of DCE-MRI in diagnosis of prostate cancer. Methods 30 cases of prostate cancer（PCa） and 30 cases of benign prostatic hyperplasia（BPH） were studied in our study. DCE-MRI and puncture biopsy of prostate were performed in all cases. Semiquantitive parameters including type of time-intensity curve（TIC）,time to peak（TTP）, maximum signal intensity（SImax）,early enhanced rate（SI1＇/SImax）, and quantitive parameters including Ktrans, Kep, and Ve were measured and statistical analyzed. Results There was significant difference in TIC types between PCa group and BPH group： more than half cases enhanced with type III curve in PCa group; while about 2/3 cases enhanced with type I curve in BPH group. Semi-quantitative parameters： PCa group： TTP（115.3±32.1）s, SImax（2.73±0.62） mmol/L, SI1＇/SImax（0.79±0.21）. BPH group： TTP（271.6±29.2）s, SImax（2.25±0.54）mmol/L, SI1＇/SImax（0.53±0.30）.Among them, difference of SI1＇/SImaxand TTP was statistically significant. Quantitative parameters： PCa group： Ktrans（0.28 ＋ 0.19）/min, Kep（0.42±0.29）/min, Ve（0.61±0.28）. BPH group： Ktrans（0.17±0.26）/min, Kep（0.34±0.24）/min, Ve（0.55±0.31）. Among them, difference of Ktrans and Kep values were statistically significant. In all those cases with Type II curve in two groups, difference of Ktrans value between groups was still statistically significant. Conclusion DCE-MRI could provide important information for the differential diagnosis of prostate cancer and benign prostatic hyperplasia. Diagnosis of BPH with Type I curve and PCa with Type III have high accuracy. Quantitative parameters Ktrans, Kep have further information for PCa diagnosis.