磁共振扩散峰度成像在前列腺癌诊断中的临床应用价值

The Clinical Value of Magnetic Resonance Diffusion Kurtosis Imaging in Prostate Cancer Diagnosis

目的探讨3.0T磁共振扩散峰度成像(diffusion kurtosis imaging,DKI)各参数在前列腺癌、前列腺增生与良性外周带组织中的表现特征,为应用该技术诊断前列腺癌提供依据。方法回顾性分析我院行常规前列腺MRI及DKI检查的患者48例,最终纳入前列腺癌者16例、前列腺增生者23例、良性外周带组织37个。采用单因素方差分析及Tukey HSD法比较DKI各参数及ADC值在前列腺癌、前列腺增生以及良性外周带组织间的差异,采用受试工作者特征曲线比较各参数在前列腺癌与良性外周带组织间的诊断效能。结果 DKI各参数(MK、Ka、Kr、FA、MD、Da、Dr)值及ADC值在前列腺癌、前列腺增生及良性外周带间比较均具有显著统计学差异(P<0.001)。前列腺癌与良性外周带比较,DKI各参数值及ADC值均显示出显著统计学差异(P<0.001);与基质增生比较,仅MK值显示出统计学差异(P<0.05);与非基质增生比较,MK、Ka、Kr、MD、Da、Dr值及ADC值均显示出显著统计学差异(P<0.001),FA值显示出统计学差异(P<0.05)。ROC曲线分析结果显示出,DKI各参数值及ADC值的曲线下面积分别均大于0.9。结论 DKI有助于前列腺癌、前列腺增生与良性外周带组织的鉴别,对前列腺癌的定性和定位诊断具有重要的临床应用价值。

Objective To evaluate the different features in parameters of diffusion kurtosis imaging(DKI)between prostate cancer,benign prostatic hyperplasia(BPH),and benign peripheral zone(PZ),to provide the evidence for diagnosis prostate cancer by this technique.Methods To retrospective analysis 48 patients which performed conventional MRI and DKI exams in Air Force General Hospital.16 patients with prostate cancer,23 patients with BPH and 37 benign PZ were enrolled.The parameters of DKI and ADC were compared using one-way analysis of variance(AVOVA)with patients as a random effect,Post hoc Turkey honestly significant difference(HSD)test for pairwise comparisons were used to determine whether there was any significant difference between prostate cancer,BPH and benign PZ.In addition,receiver operating characteristic(ROC)analyses were performed to evaluate the diagnostic performance of the parameters to discriminate prostate cancer from benign PZ.Results There is a significant difference in the parameters of DKI(MK,Ka,Kr,FA,MD,Da,Dr)and ADC between prostate cancer,BPH and benign PZ(P<0.001).The parameters of DKI and ADC all showed significant difference between prostate cancer and benign PZ(P<0.001).MK showed significant difference between prostate cancer and stromal BPH(P<0.05).MK,Ka,Kr,MD,Da,Dr and ADC showed significant difference between prostate cancer and nonstromal BPH.On the ROC analyses,the AUC of DKI parameters and ADC were all higher than 0.9.Conclusion DKI is the most useful technique in diagnostic differentiation of prostate cancer from BPH and benign PZ.DKI plays a significant role in locating and diagnosing prostate.