磁共振动态增强TIC曲线及K^(trans)值在前列腺癌诊断中的对比

Comparative study of time-intensity curve and K^(trans) value of dynamic contrast-enhanced MRI in the diagnosis of prostate cancer

目的:对比研究磁共振动态增强TIC曲线及K^(trans)值在前列腺癌诊断中的应用价值。方法:搜集本院行前列腺DCE-MRI以及穿刺病理活检的前列腺癌(PCa)及良性前列腺增生(BPH)各36例;DCE-MRI原始数据经TISSUE 4D软件进行图像后处理,绘制病灶感兴趣区(ROI)及对侧对照ROI,绘制时间信号曲线(TIC)并进行PI-RADS评分,测量定量参数K^(trans)值,并进行统计学分析。结果:PCa组:病灶与对照ROI的PI-RADS评分均值分别为3.47、2.36,差异有显著统计学意义(P=0.000),病灶与对照ROI的K^(trans)值分别为(0.270±0.151)/min、(0.216±0.116)/min,差异有统计学意义(P=0.028)。BPH组:可疑病灶与对照ROI的PI-RADS评分均值分别为2.22、1.94,差异无统计学意义(P=0.069)、病灶与对照ROI的K^(trans)值分别为(0.199±0.110)/min、(0.183±0.099)/min,差异无统计学意义(P=0.415)。以PIRADS评分及K^(trans)值诊断PCa的ROC曲线下面积分别为0.854、0.632。结论:DCE-MRI对前列腺癌的诊断提供了重要信息,其中TIC曲线的PI-RADS评分以及定量参数K^(trans)值对诊断PCa有重要价值,前者诊断效能高于后者,诊断实践中宜综合应用。

Objective：To investigate the value of time-intensity curve（TIC）and K^（trans） derived from dynamic contrastenhanced MRI（DCE-MRI）in the diagnosis of prostate cancer.Methods：36patients with prostate cancer（PCa）and 36 patients with benign prostatic hyperplasia（BPH）were collected in our study.DCE-MRI and puncture biopsy of the prostate were performed for each case.Lesion ROI and contralateral ROI（as the control）were defined in TISSUE-4Dsoftware;and PI-RADS scores of TIC and K^（trans） values were measured and statistically analyzed.Results：In PCa group,the mean PI-RADS score of the lesion and the control ROI were 3.47 and 2.36,respectively.The difference was statistically significant（P=0.000）.The K^（trans） values of the lesions and control ROI were（0.270±0.151）/min,（0.216±0.116）/min,respectively.The difference was not statistically significant（P=0.028）.In BPH group,mean PI-RADS score of the lesion and the control ROI were 2.22 and 1.94,respectively.The difference was not statistically significant（P=0.069）.The K^（trans） values of the lesions and the control ROI were（0.199±0.110）/min and（0.183±0.099）/min,respectively.The difference was not statistically significant（P=0.415）.The area under the receiver-operating-characteristic（ROC）of PI-RADS score and K^（trans） value were 0.854 and 0.632,respectively.Conclusions：DCE-MRI can provide important information for the diagnosis of prostate cancer.Both PI-RADS score of the TIC and K^（trans） values are valuable for the diagnosis,and the former has better diagnostic performance than the latter.Comprehensive analysis should be applied in the clinical practice during DCE-MRI.