3.0T磁共振T2WI联合DWI及DCE对前列腺癌的诊断价值

The diagnostic ability of T2WI combined with diffusion weighted imaging and dynamic contrast-enhanced MRI for prostate cancer detection using 3.0 T MR scanner

目的探讨3.0 T磁共振T2WI联合DWI及DCE对前列腺癌的诊断价值。材料与方法对经病理证实的前列腺疾病患者的影像资料进行回顾性分析,共75例,包括40例前列腺癌患者,35例非癌患者,均行常规T2WI、DWI及动态增强MRI(DCE-MRI)检查,对T2WI、T2WI+DWI、T2WI+DCE及T2WI+DWI+DCE共四种方法所得的图像进行诊断并评分,同时与病理结果对比,分析四种检查方法对前列腺癌诊断的敏感度、特异度和准确度。结果四种方法对前列腺癌诊断敏感度、准确度有统计学意义(Q值分别为15.391、15.61,P<0.01)。四种方法敏感度及准确度两两比较,T2WI与T2WI+DWI+DCE,T2WI+DWI与T2WI+DWI+DCE之间差异有统计学意义(P值均<0.05)。结论 3.0 T磁共振T2WI+DWI+DCE可提高前列腺癌诊断的敏感度及准确度,对前列腺癌有较高的诊断价值,T2WI+DWI的诊断效能略逊于T2WI+DWI+DCE,对难以耐受长时间检查的高龄患者可以作为常规MRI诊断序列。

Objective： To evaluate the diagnostic ability of T2-weighted imaging（T2WI） combined with diffusion weighted imaging（DWI） and dynamic contrastenhanced MRI（DCE-MRI） for prostate cancer detection using 3.0 T MR scanner.Materials and Methods： Seventy-five prostate diseases patients pathologically proved underwent MRI examinations, including 40 patients with prostate cancer and35 patients with non-prostate cancer. All patients were performed traditional MRI（T2WI） and functional MRI（DWI and DCE-MRI）. The data obtained from T2 WI,T2WI and DWI, T2 WI and DCE and a combination of T2 WI, DWI and DCE were scored and compared with pathological findings. Specificities, sensitivities and accuracies of the four protocols to diagnose PCa were evaluated. Results： The sensitivity and accuracy of four methods to prostate cancer diagnostic showed statistical significance（Q=15.391, 15.61, respectively. P〈0.01）. Pairwise comparison of sensitivity and accuracy between four methods, there was significant differences between T2 WI and T2WI＋DWI＋DCE, T2WI＋DCE and T2WI＋DWI＋DCE（P〈0.05）.Conclusions： The combination of T2 WI and DWI and DCE-MRI can improve the sensitivity and accuracy of prostate cancer detection, and be of high diagnostic value for prostate cancer. The diagnosis efficiency of T2WI＋DWI was slightly worse than T2WI＋DWI＋DCE, when elderly patients were hard to be checked for a long time, it can be as conventional MRI sequences.