3.0T磁共振诊断前列腺癌的效能:T2WI联合DWI及DCE

The Diagnostic Efficacy of 3.0T MR Scanner for Prostate Cancer Detection:T2WI Combined with DWI and DCE

目的基于第二版前列腺影像报告和数据系统(PI-RADSV2)评分比较3.0T磁共振T2WI联合DWI及DCE序列诊断前列腺癌的效能。方法对123例经病理证实的前列腺疾病患者的磁共振影像学资料进行回顾性分析,所有患者均行T2WI、DWI、动态增强MRI(DCE-MRI)检查,依据PI-RADS V2评分标准与病理结果对比分析T2WI、T2WI+DWI、T2WI+DCE、T2WI+DWI+DCE四种方法对前列腺癌的诊断能效。结果共123例患者纳入本研究,其中72例前列腺癌患者,51例非前列腺癌患者。经MedCalc软件分析后T2WI、T2WI+DWI、T2WI+DCE、T2WI+DWI+DCE四种方法诊断前列腺癌的ROC曲线下面积(AUC)分别为0.911、0.936、0.935、0.962,AUC两两比较T2WI与T2WI+DWI、T2WI与T2WI+DCE、T2WI与T2WI+DWI+DCE、T2WI+DWI与T2WI+DWI+DCE、T2WI+DCE与T2WI+DWI+DCE存在统计学差异,P值分别为0.010、0.016、0.001、0.015、0.012,T2WI+DWI与T2WI+DCE无统计学差异(P=0.870),各组最佳诊断阈值均为PIRADS分值=3。四种方法诊断前列腺癌的能效:T2WI+DWI+DCE序列的灵敏度、特异度最高(93.1%、92.2%),T2WI最低(88.9%、86.3%),T2WI+DWI(90.3%、88.2%)略高于T2WI+DCE(88.9%、88.2%)。结论基于PI-RADS V2评分3.0T磁共振各序列诊断前列腺癌的能效不同,T2WI联合DWI、DCE诊断效能最高,是诊断前列腺癌的最佳组合序列。

Objective To explore the diagnostic efficacy of T2WI combined with DWI and DCE-MRI for detecting prostate cancer using 3.0 T MR scanner based on prostate imaging reporting and data system version 2(PI-RADS V2).Methods A total of 123 patients with pathologically confirmed prostate diseases were included for this retrospective study and all ceses were scanned with traditional MRI(T2WI)and functional MRI(DWI and DCE)before biopsy.The diagnostic efficacy of T2WI,T2WI+DWI,T2WI+DCE,T2WI+DWI+DCE compared with pathological results were analyzed according to PIRADS V2.Results Of the 123 prostate diseases patients,72 were with prostate cancer and 51 with non-prostate cancer.The AUC of T2WI,T2WI+DWI,T2WI+DCE,T2WI+DWI+DCE for predicting prostate cancer based on PI-RADS score was 0.911,0.936,0.935,0.962,respectively.Significant differences of AUC were found between T2WI and T2WI+DWI(P=0.010).T2WI and T2WI+DCE(P=0.016),T2WI and T2WI+DWI+DCE(P=0.001),T2WI+DWI and T2WI+DWI+DCE(P=0.015),T2WI+DCE and T2WI+DWI+DCE(P=0.012),but not between T2WI+DWI and T2WI+DCE(P=0.870)through MedCalc software and the best cut-off point was PI-RADS 3 of each sequence.The sensitivity and specificity of T2WI,T2WI+DWI,T2WI+DCE,T2WI+DWI+DCE for predicting prostate cancer were 88.9%and 86.3%,90.3%and 88.2%,88.9%and 88.2%,93.1%and 92.2%,respectively.Conclusion The diagnostic efficacy of 3.0 T MR scanner for prostate cancer detection between sequences based on PI-RADS V2 were different and the combination of T2WI+DWI+DCE with the highest diagnostic value can be as the best combination approach.