DWI联合MRS诊断中老年前列腺癌的临床研究

Clinical study of DWI combined with MRS in the diagnosis of elderly patients with prostate cancer

目的:探讨磁共振的扩散加权成像联合磁共振波谱分析诊断中老年前列腺癌的临床价值。方法:选择2015年12月至2016年6月我院收治的前列腺疾病患者126例,所有患者均行病理活检或者手术后病理诊断,病理检查前均行DWI、MRS检查,以手术病理诊断结果作为金标准,计算患者MRS检查、DWI检查结果,采用四格诊断表,输入数据,计算DWI、MRS、DWI联合MRS与病理诊断结果的Kappa一致性系数,DWI、MRS、DWI联合MRS诊断的敏感性、特异性和准确性。结果:126例患者病理诊断结果:42例为前列腺癌,32例为前列腺良性增生,52例为前列腺炎。DWI检查前列腺癌阳性36例,阴性90例,MRS检查前列腺癌阳性35例,阴性91留,DWI联合MRS诊断前列腺癌阳性41例,阴性85例,DWI、MRS、DWI联合MRS与手术病理诊断的Kappa一致性系数为0.712、0.726、0.873,DWI联合MRS诊断前列腺癌与病理诊断具有高度的一致性;DWI联合MRS诊断前列腺癌的敏感、特异性均明显高于DWI和MRS。结论:DWI联合MRS对中老年前列腺癌的诊断具有较高的灵敏度、特异性和准确性,具有较高的临床价值。

Objective：To analyze the clinical value of MR diffusion weighted imaging combined with magnetic resonance spectroscopy in the diagnosis of middle and advanced prostate cancer.Methods：The data of 126 patients with prostate disease admitted in our hospital from December 2015 to June 2016 were enrolled in all patients.All patients underwent pathologic biopsy or postoperative pathological diagnosis.DWI and MRS were performed before pathology.The results of surgical pathology were difference in Kappa consistency coefficient between DWI,MRS,DWI combined with MRS and pathologic diagnosis was calculated by using the four-line diagnostic table and input data.The sensitivity of DWI,MRS,DWI combined with MRS was analyzed by MRS and DwI.Specificity and accuracy.Results：126 cases of pathological diagnosis of patients,42 cases of prostate cancer,32 cases of benign prostatic hyperplasia,52 cases of prostatitis.DWI,MRI,DWI combined with MRS in the diagnosis of prostate cancer in 41 cases,negative in 85 cases,DWI,MRS,DWI combined with MRS and surgical pathology diagnosis of prostate cancer positive in 36 cases,negative in 90 cases,MRS examination of prostate cancer positive in 35 cases,The Kappa consistency coefficient were 0.712,0.726 and 0.873.DWI combined with MRS was highly consistent with pathological diagnosis.The sensitivity and specificity of DWI combined with MRS in the diagnosis of prostate cancer were significantly higher than those of DWI and MRS.Conclusion：DWI combined with MRS had a high sensitivity,specificity and accuracy in the diagnosis of middle and advanced prostate cancer,and had high clinical value.