MR动态增强定量参数对鉴别前列腺良恶性病变的价值及与血清PSA的相关性

The Study of Dynamic Contrast-enhanced MR Quantitative Parameters in Differential Diagnosis of Benign and Malignant Prostate Lesions and the Correlation with Serum PSA

目的:探讨MR动态增强(DCE-MRI)定量测量在前列腺良、恶性病变鉴别诊断中的价值以及定量参数值与血清特异性抗原(PSA)的相关性。方法:回顾性分析75例行DCE-MRI扫描且经病理穿刺活检证实的前列腺疾病患者,其中前列腺癌(PCa)30例,前列腺增生(BPH)45例。测量两组病变感兴趣区(ROI)定量参数K^(trans)、K_(ep)、V_e值,采取独立样本t检验进分析比较,并分析三组数值与PSA的关系。结果:K^(trans)及K_(ep)值在PCa和BPH组间差异均有统计学差异(P<0.01),V_e值无统计学意义(P=0.72);PCa组K^(trans)、K_(ep)值与血清PSA值呈正相关(r值分别为0.49、0.63,P<0.05),V_e值与血清PSA值无相关性(r=0.78,P>0.05);BPH组K^(trans)、K_(ep)、V_e值与血清PSA值均无相关性(r=0.0.36、-0.077、-0.045,P>0.05)。结论:定量参数K^(trans)及K_(ep)值对PCa和BPH的鉴别诊断有重要价值,V_e无明显价值,且PCa K^(trans)、K_(ep)值与血清PSA值呈正相关,可为PCa的诊断提供参考。

Purpose： To investigate the value of quantitative measurement of MR dynamic enhancement （DCE- MRI） in differential diagnosis of benign and malignant prostate lesions and the correlation between quantitative parameters and serum specific antigen （PSA）. Methods： Seventy-five cases pathological biopsy confirmed prostate disease, who had undergone routine MRI dynamic enhanced scans, were retrospectively analyzed. Of these patients, 30 cases were with malignant changes of prostate, 45 cases were with benign lesions. The quantitative parameter Ktrans, Kep, Ve of the lesions were measured and compared between the two groups using independent sample t-test, and the correlations between Ktrans, Kep, Ve and PSA was also analyzed. Results： There were significant differences of K-nS and K-p values between the benign and malignant prostate group （P〈0.01）, and there was no significant differences of the Vc value between them （P=0.72）. The Kt and Kc0 values of prostate cancer group were positively correlated with serum pSA （r=0.49, 0.63, P〈0.05）, no correlation was existed between PSA values and Vo values （r=0.78, P 〉 0.05）. There was no correlation between Ktrans, Kep, Me and serum PSA value in benign prostatic hyperplasia （r=0.0.36, -0.077, -0.045, P 〉 0.05）. Conclusion： Quantitative parameters Ktrans and Kop value have important value in differential diagnosis of benign and malignant prostate lesions. The Vo value had no significant value, and the Ktrans, Kep value of Pca was positively correlated with serum PSA value, which can provide reference for the diagnosis of Pca.