DCE-MRI定量参数联合ADC值和血清PSA对前列腺中央区腺体癌的诊断价值

Diagnostic value of quantitative parameters of dynamic contrast enhanced MRI in combination with ADC Values and serum PSA in cancer of prostatic central area

目的:探讨磁共振动态增强扫描(DCE-MRI)定量参数联合ADC值和血清前列腺特异性抗原(PSA)对前列腺中央区腺体癌(CGPCa)的诊断价值。方法:128例前列腺中央区病变患者(72例CGPCa和56例良性前列腺增生)均行前列腺DCE-MRI检查,所有患者均获得病理结果,测量病灶容量转移常数(K^(trans))、速率常数(K^(ep))、血管外细胞外间隙容积比(V_e)及ADC值,同时记录患者的血清PSA。采用独立样本t检验(正态分布)或Mann-Whitney U检验(非正态分布)比较良恶性病变组上述指标的差异;采用受试者工作特征(ROC)曲线评价上述各指标对良、恶性病变的诊断效能。结果:CGPCa与良性前列腺增生的K^(trans)、K^(ep)、ADC值、血清总前列腺特异性抗原(tPSA)、游离前列腺特异性抗原(fPSA)差异均有统计学意义(P值均<0.05),Ve值差异无统计学意义(P=0.615)。K^(trans)、K^(ep)、ADC值具有较高的诊断效能,ROC曲线下面积(AUC)分别为0.809、0.803、0.944(P<0.05);血清PSA的诊断敏感度较低,但是联合DCE-MRI定量参数可以显著提高诊断敏感度和诊断效能;V_e值无诊断效能(P=0.958)。结论:K^(trans)、K^(ep)及ADC值对于CGPCa具有重要的诊断价值,而血清tPSA联合DCE-MRI定量参数则可明显提高诊断敏感度及诊断效能。

Objective：To explore the diagnostic value of quantitative parameters of dynamic contrast enhanced MRI（DCE-MRI）in combination with ADC value and serum PSA in cancer of prostatic central area.Methods：One hundred and twenty-eight patients had pathology proven lesion in the central area of prostate gland（72 cases with cancer,56 cases with hyperplasia）,all underwent DCE-MRI.The Ktrans,Kep,Ve and ADC values were measured and serum PSA were recorded.T test or MannWhitney U test was used to compare the difference of Ktrans,Kep,Ve,ADC value and PSA between the benign/malignant lesions.The ROC curve was used to evaluate the diagnostic efficiency of Ktrans,Kep,Ve,ADC values and PSA.Results：The Ktrans,Kep,ADC values and PSA were statistically different between cancer in the central area and benign prostatic hyperplasia（P〈0.05）.However,the V_e value was not statistically different（P=0.615）.The Ktrans,Kep,and ADC values had a relatively high diagnostic efficiency,and their AUC were 0.809,0.803 and 0.944,respectively（P〈0.05）;the serum PSA had a low diagnostic sensitivity,but in combination with the quantitative parameters of DCE-MRI it could significantly improve the sensitivity and the diagnostic efficiency.The Ve value had no diagnostic capability.Conclusions：The Ktrans,Kep,and ADC values have an important diagnostic value in the cancer of prostatic central area.Serum PSA in combination with the quantitative parameters of DCE-MRI can significantly improve the sensitivity and diagnostic efficiency.