3.0T磁共振弥散张量成像在前列腺中央腺区病变的诊断价值

The Diagnostic Value of 3.0T Magnetic Resonance Diffusion Tensor Imaging on Disease of Prostate Central Zone

目的探讨3.0T磁共振扩散张量成像对前列腺中央腺体区病变的鉴别诊断价值。方法分析行常规磁共振检查和扩散张量成像检查并经病理证实的CZ-PCa15例和BPH 20例、健康志愿者10例,分别测量三组病例的表观扩散系数值和各向异性值,观察三组之间的差异。运用种子点法对病灶最大层面的纤维进行追踪,得到DTT图,由2名高年资磁共振诊断医生采用4级评分制对其进行评分,比较3组病例纤维的走行、密度及连续性的差异。结果 CZ-PCa组ADC值为(1026±176)×10^(-6)mm^2/s、FA值为(0.46±0.02)×10^(-1);BPH组ADC值为(1351±143)×10^(-6)mm^2/s、FA值为(0.23±0.04)×10^(-1);健康志愿者组ADC值为(1458±188)×10^(-6)mm^2/s、FA值为(0.22±0.05)×10^(-1),3组间ADC值差异有统计学意义(P<0.05),FA值间差异无统计学意义(P>0.05)。2名医师对3组DTT图评分一致性较好(k=0.723),CZ-PCa组评分分别为2.8±0.9、2.9±0.4;BPH组为1.6±0.8、1.7±0.42;健康志愿者组为1±0.2、1±0.3。三组差异具有统计学意义(P<0.05)。结论在CG-PCa和BPH的鉴别诊断中ADC值中具有重要价值,DTT图更能直观地展现了前列腺纤维束,对两者的鉴别具有一定的价值。

Objective To research the application value of 3.0T magnetic resonance diffusion tensor imaging in the central zone lesions of prostate. Methods Ten healthy volunteers, 15 CG-PCa cases and 20 BPH cases proven by histopathology were performed MRI and DTI. ADC values and FA values of CG-PCa and BPH were respectively measured, comparing whether there is any discrepancies among the three groups. For DTT maps, two observers recorded the score using a four-point scale and compared the differences of fibers continuity and density in the three groups. Results ADC values and FA values in CZ-PCa were：（1026±176）×10^（-6）mm2/s,（0.46±0.02）×10^（-1）. BPH were（1351±143）×10^（-6）mm2/s,（0.23±0.04）×10^（-1）, healthy volunteers were（1458±188）×10^（-6）mm2/s,（0.22±0.05）×10^（-1）. ADC value of the three groups were statistically different（P〈0.05）while FA values was not（P〈0.05）. The DTT map score of CZ-PCa were（2.8±0.9）,（2.9±0.4）, the BPH were（1.6±0.8）,（1.7±0.42）, healthy volunteers were T（1±0.2）,（1±0.3）. The consistency score of the three groups by two observers was good（k=0.723）. The DTT map score between the three groups for two viewers were all significantly different（P〈0.05）. Conclusion ADC values can play a significant role in the differentiation of CG-PCa and BPH. DTT maps can show prostate fibers more Intuitively and it is helpful in differentiating PCa from BPH.