IVIM-DWI对外周带前列腺癌的诊断价值

Value of IVIM-DWI in diagnosis of peripheral zone prostate cancer

目的:探讨3.0TMR体素内不相干运动扩散加权成像(IVIM-DWI)定量参数对外周带前列腺癌(PCa)的诊断价值.方法:回顾分析经超声引导穿刺病理证实的51例外周带前列腺病变患者资料,其中27例为前列腺癌患者(恶性组)、36例为良性前列腺增生(BPH)和/或慢性前列腺炎(CP)患者(良性组).对所有患者均行前列腺常规MRI扫描及体素内不相干运动磁共振扩散加权成像(IVIM-DW)扫描,IVIM-DWI采用14个b值(b=0、25、50、75、100、150、200、400、600、800、1 000、1 200、1 500、2 000 s/mm^2).GE ADW4.6 Functool后处理软件计算病变组织内感兴趣区的表观扩散系数(ADC)、纯水分子扩散系数(D值)、灌注相关扩散系数(D~*值)及灌注分数(f值).采用独立样本t检验比较PCa组和BPH组各参数值的差异,对于两组间具有统计学差异的参数值,建立受试者工作特征曲线分析各参数值对前列腺癌的诊断效能.结果:PCa组的ADC值、D值及f值均明显低于BPH组,有统计学差异(P<0.05).各组间D~*值无统计学差异(P=0.581).结论:IVIM的定量参数ADC值、D值对外周带前列腺良恶性病灶的诊断及鉴别价值均较高,以ADC值的诊断效能最优.

Objective:To investigate the diagnostic value of quantitative parameters of 3.0 TMR intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)in diagnosis of peripheral zone prostate cancer(PCa).Methods:The data of 51 patients with peripheral zone prostatic lesions confirmed by ultrasound-guided biopsy were retrospectively analyzed,including 27 patients with prostate cancer(malignant group),36 patients with benign prostatic hyperplasia(BPH)and/or chronic prostatitis(CP)patients(benign group).Routine MRI and IVIM-DWI were performed in all patients.IVIM-DWI was performed with 14 b values(b=0,25,50,75,100,150,200,400,600,800,1000,1200,1500,2000 s/mm^2).GE ADW4.6 Functool post-processing software was used to calculate the apparent diffusion coefficient(ADC),pure water molecular diffusion coefficient(D),perfusion- related diffusion coefficient(D^* value)and perfusion fraction(f value)of the region of interest in the lesion.Independent sample t test was used to compare the differences of parameters between PCa group and BPH group.For the parameters with statistical significance between the two groups,the work characteristic curve of subjects was established to analyze the diagnostic efficacy of each parameter value for prostate cancer.Results:The ADC value,D value and F value of group PCa were significantly lower than those of BPH group(P<0.05).There was no significant difference in D^* between groups(P=0.581).Conclusion:The ADC and D values of IVIM are of high value in the diagnosis and differential diagnosis of benign and malignant peripheral prostate lesions,and the ADC value is the best.