表观扩散系数与表观扩散系数比值对前列腺癌的诊断价值及与病理分级的相关性

Apparent Diffusion Coefficient and Apparent Diffusion Coefficient Ratio on the Diagnosis of Prostate Cancer and Their Relationship with Gleason Scores

目的探讨MR表观扩散系数(ADC)值与ADC比值在前列腺癌中诊断的价值,及其与病理Gleason评分的相关性,评估肿瘤的侵袭性。资料与方法回顾性分析疑诊前列腺癌而行前列腺磁共振-经直肠超声融合成像引导穿刺活检的116例患者,术前行前列腺MRI检查,常规扫描T1WI、T2WI及扩散加权成像序列,以b=0、1000 s/mm^2建立ADC图,测量病灶ADC值、对称位置相对正常前列腺ADC值,并计算两者的比值,以穿刺活检病理为对照,评估前列腺MRI的ADC值、ADC比值对前列腺癌的诊断价值,并评估其与病理Gleason评分的相关性。结果 116例患者穿刺活检前列腺癌检出率为56.0%(65/116)。ADC值及ADC比值诊断前列腺癌的ROC曲线下面积分别为0.842、0.879。ADC值及ADC比值在Gleason 6分组与Gleason 7分组间比较,差异有统计学意义(P<0.05),其余组间差异无统计学意义(P>0.05)。结论 ADC值及ADC比值对前列腺癌有较高的诊断价值,两者数值高低可初步判定低危与高危前列腺癌。

Purpose To investigate the value of apparent diffusion coefficient（ADC） and ADC ratio on the diagnosis of prostate carcinoma and their relationship with Gleason scores and evaluate the aggressiveness of prostate cancer. Materials and Methods For 116 patients confirmed prostate cancer by biopsy were included in this study. Each patient had suspicious lesions on T1WI, T2WI, DWI or ADC map（b=0, 1000 s/mm^2）. ADC and ADC ratio of suspicious lesions and symmetrical normal tissue were obtained. All patients underwent magnetic resonance imaging-transrectal ultrasound guided biopsy and 12-core systematic biopsy. The diagnostic value of MRI and their relationship with Gleason scores was analysis. Results Among 116 patients, the detective rate of prostate cancer was 56.0%（65/116）. The area under roc curve of ADC and ADC ratio were 0.842 and 0.879, respectively. There was statistically significance in ADC value and ADC ratio between Gleason scores of 6 and 7（P〈0.05）; and no statistically significance among the other groups（P〉0.05）. Conclusion The ADC value and ADC ratio are remarkably lower in prostate cancer than those in other diseases. Decrease of ADC value and ADC ratio may represent high risk of poorly differentiated cancer.