多b值弥散成像诊断中央区前列腺结节的价值

Value of of Different B Value of Diffusion-Weighted Imaging in the Diagnosis of Central Prostate Nodules

目的探讨高场强磁共振多b值弥散加权成像在结节性的中央区前列腺癌与增生中的鉴别诊断价值。方法共37例可疑前列腺中央区恶性结节患者进行了3.0 T多b值弥散成像检查,全部患者经病理检查证实。分析每例患者的常规磁共振图像和弥散图像,测量病变区域的表观弥散系数(ADC),比较良恶性结节的ADC数值差异,探讨Gleason评分与ADC值变化的关系。结果 37例患者共发现52个结节,其中良性结节25个,恶性结节27个。当b值为2000 s/mm2时,以1.0×10^(-3) mm^2/s为分界值,诊断前列腺癌的敏感度、特异度和准确度分别是70.90%、89.10%和91.32%。良恶性结节的ADC值均随着b值的升高呈下降趋势,但两者差异无显著性意义。恶性结节的ADC值与Gleason评分呈负性相关关系。结论前列腺恶性结节的ADC值低于增生性结节,高b值弥散成像技术在前列腺癌的鉴别诊断中具有更大的价值。

Objective To evaluate the diffusion-weighted imaging with different B value in diagnosis of nodular hyperplasia and cancer in the central region of prostate.Methods A total of37patients with suspected prostatic central malignant nodules were evaluated with diffusion weighted imaging in3.0T magnetic resonance imaging.All the patients were confirmed by pathological examination.Conventional magnetic resonance imaging and diffusion-weighted imaging were analyzed in each patient.The apparent diffusion coefficient(ADC)of the lesion area was measured.The differences of ADC value in benign and malignant nodules were analyzed.The relationship between Gleason score and ADC value was discussed.Results52nodules were found in37patients,including25benign nodules and27malignant nodules.When b value was2000,the sensitivity,specificity and accuracy were70.90%,89.10%and91.32%,respectively,with the ADC value of1.0×10-3mm2/s.The ADC value of benign and malignant nodules showed a downward trend with the increase of b value without statistical significance.The ADC value of malignant nodules was negatively correlated with Gleason score.Conclusion The ADC value of malignant prostatic nodules is lower than that of hyperplastic nodules,and high B diffusion imaging is of great value in differential diagnosis of prostate cancer.