计算机化DWI在前列腺良恶性病变的应用价值

A Pilot Study of Computed Diffusion-Weighted Imaging in Benign and Malignant Prostate Disease

目的初步探讨计算机化扩散加权成像(c DWI)在前列腺良恶性病变中的诊断价值。方法纳入前列腺特异性抗原(PSA)筛查异常的59例患者,以3.0 T磁共振行前列腺DWI(b=0,800)扫描,计算c DWI(b=1400)。测量DWI 800和c DWI 1400的病灶对比度CR 800和CR 1400,以配对t检验分别比较DWI 800和c DWI 1400的对比度。由2名医师以方案A(T_2WI+DWI 800)、方案B(T2WI+c DWI 1400)对所有患者进行回顾性诊断,诊断结果以受试者工作特征曲线(ROC)进行诊断效能分析。结果 59例中29例为前列腺癌,30例为前列腺良性病变。癌组CR 1400显著高于CR 800,差异有统计学意义。ROC分析显示方案A的曲线下面积(AUC)为0.795,方案B的AUC为0.964,方案B诊断效能显著优于方案A。结论 c DWI 1400可显著提高前列腺癌灶的对比度,其诊断效能优于常规DWI 800。

Objective To evaluate the value of computed diffusion-weighted imaging （cDWI, b = 1400 ） which was calculated from DWI （b = 0,800） in the diagnosis of prostate disease. Methods MR imaging including DWI800, and DCE-MR was performed using a 3.0 T MR scanner in 59 cases. CDWII400 was automatically calculated from DWI800. Contrast ratios （CR） 800 and CR1400 from DWI800 and cDWI1400 were measured. The paired t test was used to compare the CR800 and CR1400. Two combinations of images, protocol A （T2WI ＋ DWI800） and B （T2WI ＋ cDWI1400） , were assessed for their diagnostic capability by use of receiver operating characteristic curve （ROC）. Diagnosis was confirmed by histopathology. Results Twenty-nine of the 59 cases were confirmed to be cancerous, and 30 of 59 cases were noncan- cerous. The CR1400 was significantly higher than CR800 in the cancerous group （ P 〈 0. 001 ）. Areas under the receiver operating characteristic curve （ AUC ） of protocol A was 0. 795, protocol B was 0. 964. Protocol B has a higher diagnostic power than protocol A. Conclusion cDWI1400 appears to be more effective than DWI800 in the detection and diagnosis of prostate cancer; the diagnostic efficiency improved significantly.