磁共振DWI及ADC值在前列腺疾病中的应用价值

目的 评价磁共振（MRI）弥散加权成像（DWI）及表观弥散系数（ADC）在前列腺疾病中的诊断价值.方法 回顾性分析经病理证实的25例外周带前列腺癌（PZPCa）,10例中央腺体癌（CGPCa）,30例前列腺增生（BPH）患者及15例正常前列腺志愿者的MRI资料,并分别测量其ADC值,比较各组间ADC值的差异.将PZPCa与CGPCa合并为前列腺癌（PCa）,并绘制ROC曲线,分析PCa的诊断最佳临界值.结果 PZPCa及CGPCa的DWI表现为高信号,ADC值均低于BPH及正常前列腺,组间两两比较,除了PZPCa及CGPCa组的ADC值差异无统计学意义（P〉0.05）,其余各组的ADC值差异均有统计学意义（P〈0.01）.根据ROC曲线分析,以1.14＆#215;10-3mm2/s为诊断PCa的最佳临界值,对应的敏感度及特异度为86.7%、85.3%.结论 DWI和ADC值在前列腺疾病的诊断及鉴别中有重要价值,为PCa的临床诊断及治疗提供有力依据.

Objective To evaluate the diagnostic value of magnetic resonance imaging（MRI）diffusion weighted imaging（DWI）and apparent diffusion coefficient（ADC）in prostate disease. Methods MRI data of 25 patients with peripheral zone prostate cancer（PZPCa）, 10 patients with central gland prostate cancer（CGPCa）,30 patients with benign prostatic hyperplasia（BPH）and 15 normal prostate volunteers were retrospectively analyzed,all patients were confirmed by pathology,and their ADC values were measured separately. The differences in ADC values between groups were compared. The prostate cancer（PCa）group was set which included CGPCa and PZPCa patients. The receiver operating characteristic（ROC）curve was drawn to determine the optimal cutoff value of PCa. Results The DWI of PZPCa and CGPCa showed high signal and the ADC value was lower than that of BPH and normal prostate. There was no significant difference in ADC value between the PZPCa group and the CGPCa group（P〉0.05）,the ADC values of the other groups were statistically significant（P〈0.01）. According to the ROC curve,with the ADC cutoff value of PCa setting at 1.14＆#215;10-3mm2/s,the sensitivity and specificity were 86.7%,85.3 %. Conclusion DWI and ADC value have important value in the diagnosis and identification of prostate disease,and provide a strong basis for clinical diagnosis and treatment of PCa.