MR扩散加权成像诊断前列腺癌的临床研究

Clinical Research of MR Diffusion Weighted Imaging in the Diagnosis of Prostate Cancer

目的探讨磁共振(MR)扩散加权成像(D W I)诊断前列腺癌的临床价值。方法选取2012年2月至2014年12月我院收治的前列腺癌患者临床资料90份为研究样本,术前1个月内均行常规磁共振扫描(T2WI)及DWI,记录T2WI、DWI、(T2WI+DWI)三种诊断方法的表观扩散系数值(ADC),同将诊断结果与组织病理结果对照,比较三种诊断方法的敏感度、特异度及准确度,并分析ADC值与前列腺癌Gleason分级、TNM分期的相关性。结果早期前列腺癌患者ADC值[(0.85±0.17)×10-3mm2/s]低于良性前列腺增生及前列腺炎患者,但组间比较无统计学意义(P>0.05),随TNM分期增加,前列腺癌患者ADC值降低,各期差异无统计学意义(P>0.05)。T2WI、DWI、T2WI+DWI三种诊断方法对早期前列腺癌的诊断灵敏度分别为66.7%、83.3%、90.0%,特异度分别为76.7%、75.0%、80.0%,准确度分别为73.3%、77.8%、83.3%,其中T2WI+DWI诊断的灵敏度明显高于T2WI(P<0.05),三种诊断方法特异度及准确度比较无显著差异(P>0.05);相关分析显示前列腺癌区ADC值与Gleason分级呈负相关(r=-0.576,P<0.05),与TNM分期无相关性(r=-0.234,P>0.05)。结论磁共振扩散加权成像对前列腺癌的诊断及临床病情评估具有较高的参考价值,值得在临床推广应用。

Objective To explore clinical value of magnetic resonance （MR） diffusion weighted imaging （DWI） in the diagnosis of prostate cancer.Methods 90 cases of clinical data of patients with prostate cancer in our hospital from February 2012 to December 2014 were selected as the research samples, conventional magnetic resonance imaging （T2WI） and DWI were performed 1 month before operation,apparent diffusion coefficient values （ADC） of three diagnostic methods [T2WI, DWI, （T2WI＋DWI）] were recorded,diagnosis results were compared with histopathological findings,sensitivity, specificity and accuracy of three diagnostic methods were compared,correlation between ADC values, prostate cancer Gleason grading and TNM staging were analyzed.Results ADC value of patients with early-stage prostate cancer [（0.85±0.17）×10^-3mm^2/s] was slightly lower than patients with benign prostatic hyperplasia and prostatitis patients （P〉0.05）,with the increase of TNM stage, ADC values of prostate cancer patients was reduced, and there was no significant difference in each period （P〉0.05）. Diagnostic sensitivity to early-stage prostate cancer of three diagnostic methods （T2WI, DWI, T2WI＋DWI） were 66.7%, 83.3%, 90.0% respectively, specificity were 76.7%, 75.0%, 80.0% respectively, accuracy were 73.3%, 77.8%, 83.3% respectively, diagnostic sensitivity of T2WI＋DWI was significantly higher than T2WI （P〈0.05）,there was no significant difference in the specificity and accuracy of the three diagnostic methods （P〉0.05）,correlation analysis showed that ADC values of prostate cancer areas were negatively correlated with Gleason grading （r=-0.576, P〈0.05）,there was no significant correlation with TNM stage （r=-0.234, P〉0.05）.Conclusion Magnetic resonance diffusion weighted imaging has a high reference value for diagnosis of prostate cancer and evaluation of clinical condition,has a value of clinic application.