MR扩散加权成像早期诊断前列腺癌的临床应用价值分析

An analysis on the clinical application value of MR-DWI in the early diagnosis of PCa

目的:探讨磁共振(MR)扩散加权成像(DWI)在前列腺癌(PCa)早期诊断中的价值。方法:选取在医院治疗的61例PCa患者纳入观察组,同时选取70例前列腺增生患者纳入对照祖,对两组患者均行DWI扫描(b=800 s/mm2),且两组患者均经穿刺活检或手术病理证实。结果:病理结果共发现81个PCa病灶,其中中央腺病灶32个,周围带病灶49个;良性前列腺增生结节病灶118个;DWI诊断PCa的灵敏度、特异度和准确率分别为80.25%、75.42%和77.39%;DWI检查中央腺和周围带癌性病灶的检出率分别为78.13%和81.63%,差异无统计学意义(x^2=0.150,P>0.05);PCa病灶表观扩散系数(ADC)值为(0.90±0.21)×10^(-3)mm^2/s,明显低于良性前列腺增生结节病灶的(1.52±0.26)×10^(-3)mm^2/s,差异有统计学意义(t=17.833,P<0.05);中央腺和周围带癌性病灶表观弥散系数(ADC)值比较差异无统计学意义(t=1.143,P>0.05);ADC诊断PCa病灶的受试者工作特征(ROC)曲线下面积(AUC)为0.977(P<0.05),当ADC截断值为1.22×10^(-3)mm^2/s时,其诊断PCa的灵敏度和特异度分别为91.60%和92.59%。结论:DWI在早期诊断PCa中有一定应用价值,其中ADC诊断价值较高。

Objective： To explore the value of magnetic resonance（MR） diffusion weighted imaging（DWI） in the early diagnosis of prostate cancer（PCa）. Methods： 61 patients with PCa were enrolled in the observation group, and 70 patients with benign prostatic hyperplasia were divided into the control group. DWI scan（b=800 s/mm2） was performed on each patients of two groups, and all of patients of two groups were confirmed by aspiration biopsy or pathology of operation. Results： Pathological results found that there were 81 PCa lesions, which including 32 central glandular lesions and 49 surrounding lesions, and 118 benign prostatic hyperplasia nodules. The sensitivity, specificity and accuracy of DWI for diagnosing PCa were 80.25%, 75.42% and 77.39%, respectively. The detection rates of central glandular lesions and surrounding lesions detected by DWI were 78.13% and 81.63%, respectively, and the difference was not statistically significant（x2=0.150, P〉0.05）. The apparent diffusion coefficient（ADC） value of PCa lesions was（0.90±0.21）×10-3mm2/s, which was significantly lower than that of benign prostatic hyperplasia nodules（1.52±0.26） ×10-3mm2/s, and the difference was statistically significant（t=17.833, P〈0.05）. While there was no significant difference for the ADC value between central glandular lesions and surrounding lesions（t=1.143, P〉0.05）. The area under the curve（AUC） of receiver operating characteristic（ROC） of PCa lesions that diagnosed by using ADC was 0.977（P〈0.05）, and when cut-off value of ADC was 1.22×10-3mm2/s, the sensitivity and specificity of diagnosing PCa of ADC were 91.60% and 92.59%, respectively. Conclusion： DWI has a certain value in the early diagnosis of PCa, and the diagnostic value of ADC is higher.