MR—DWI联合TRUS在前列腺癌诊断及Gleason分级中的应用

Application of MR-DW1 Combined with TRUS in the Diagnosis and Gleason Classification of Prostate Cancer

【目的】探讨磁共振扩散成像（MR-DWI）联合经肠道超声检查（TRUS）对前列腺癌的诊断价值及其在Gleason分级中的应用。【方法】选取2015年6月至2017年7月本院收治的前列腺良恶性疾病患者98侧为研究对象，术前均行MR-DWl、TRUS检查，记录表观扩散系数值（ADC），并将诊断结果与病理学诊断结果比较。同时，比较不同的检测方法的敏感度、特异性、准确度，并对Adc值与Gleason评分相关性进行分析。【结果】98例中，前列腺癌43例，良性前列腺增生40例，前列腺炎15例。前列腺癌患者ADC值显著低于前列腺增生患者及前列腺炎患者，差异具有统计学意义（P〈0．05）。前列腺癌患者不同TNM分期中ADC值由大到小依次为Ⅰ期〉Ⅱ期〉Ⅲ期〉Ⅳ期，但组间比较差异无统计学意义（P〉0．05）。MR—DWI、TURS、MR—DWI＋TRUS诊断前列腺癌的敏感度分别为86．0．4％、74．48％、95．34％，特异性分别为83．63％、78．18％、89．09％，准确率分别为84．69％、74．49％、91．83％，MR—DWI＋TRUS诊断前列腺癌的准确度最高，明显高于其余两种方法。相关性分析结果显示，前列腺癌患者ADC值与Gleason评分呈负相关。【结论】MR—DWI联合TRUS对前列腺癌的诊断及病情的预测具有较高的准确性，值得在临床推广。

[Objective]To investigate the diagnostic value of magnetic resonance diffusion imaging （MR- DWI） combined with intestinal uhrasonography （TRUS） in prostate cancer and its application in Gleason clas- sification. [Methods]From June 2015 to July 2017, 98 patients with benign and malignant prostatic diseases were studied. MR-DWI and TRUS were performed before operation. The apparent diffusion coefficient was re- corded and compared with pathological diagnosis. The sensitivity, specificity and accuracy of different detection methods were compared, and the correlation between ADC and Gleason score was analyzed.[Resuhs]Among 98 cases, 43 cases were prostate cancer, 40 cases were benign prostatic hyperplasia, 15 cases were prostatitis. The ADC value of prostate cancer patients was significantly lower than that of prostatic hyperplasia patients and prostatitis patients. The difference was statistically significant （ P ~0.05）. The order of ADC in different TNM stages of prostate cancer patients was I 2〉 ]I 2〉 m 2〉 IV, but there was no significant difference be- tween the two groups （P2〉0.05）. The sensitivity of MR-DWI, TURS and MR-DWI＋TRUS to diagnose pros- tate cancer were 86.0.40/00, 74.48G, 95.340//00, specificity 83.63%, 78.18G, 89.09~, respectively, and the ac- curacy rates were 84.69G, 74.49G, 91.83~/00, respectively. The accuracy of MR-DWI TRUS in the diagnosis of prostate cancer was the highest, which was significantly higher than that of the other two methods. The correlation analysis showed that the ADC value of prostate cancer patients was negatively correlated with Glea- son score.[Conclusion]MR DWI combined with TRUS has high accuracy in diagnosis and prognosis of prostate cancer.