DCE-MRI定量分析及其在前列腺癌诊断中的疗效评估

Quantitative analysis of DCE-MRI and its assessment for therapeutic effect in diagnosing prostatic cancer

目的:探讨动态增强磁共振成像(DCE-MRI)定量分析对前列腺癌的诊断效果及疗效评估。方法:选择经手术病理检查确诊的80例前列腺癌患者纳入观察组;另选择同期入院治疗的20例前列腺增生患者纳入对照组,两组均行常规磁共振成像(MRI)和DCE-MRI检查,测量前列腺癌组织与正常组织的容积转运常数(K^trans)、速率常数(Kep)和血管外细胞外容积分数(Ve)的灌注参数,根据定量参数绘制受试者工作特征(ROC)曲线,分析DCE-MRI定量分析在前列腺癌的诊断效果;对前列腺癌患者手术后进行格里森(Gleason)评分,利用SPSS Pearson相关性分析软件对前列腺癌Gleason评分与DCE-MRI定量参数相关性进行分析。结果:观察组与对照组DCE-MRI定量参数Ve值比较无统计学意义;观察组DCE-MRI定量参数Ktrans和Kep参数均高于对照组,差异有统计学意义(t=18.242,t=16.749;P<0.05);ROC曲线结果表明:Ktrans和Kep参数曲线下面积分别为0.992和0.921,两种参数曲线下面积比较差异有统计学意义(Z=2.658,P<0.05),且均高于Ve(曲线下面积0.509);K^trans诊断灵敏度和特异度分别为92.9%和71.4%,高于Kep诊断的85.6%和58.6%;前列腺癌Gleason评分与K^trans呈负相关性(r=-0.481,P<0.05);前列腺癌Gleason评分与Kep和Ve无相关性。结论:将DCE-MRI定量分析用于前列腺癌诊断中效果理想,且与前列腺癌Gleason评分具有一定的相关性,能为临床提供影像学依据。

Objective: To investigate the diagnostic effect and the assessment of therapeutic effect of the quantitative analysis of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) in patients with prostatic cancer. Methods: 80 patients with prostatic cancer who were confirmed by pathological examination were selected as the observation group. And 20 patients with benign prostatic hyperplasia who received treatment at the same period were selected in control group. Both the routine MRI and DCE-MRI were performed in two groups. The perfusion parameters of volumetric transport constants(Ktrans), Kep and extracellular volume fraction outside blood vessel(Ve) of prostatic cancer tissues and normal tissues were measured. According to the quantitative parameters to draw receiver operator characteristics(ROC) curve, and analyze the diagnostic effect of DCE-MRI quantitative analysis in prostatic cancer. And after surgery, patients with prostatic cancer were implemented Gleason score, and Pearson correlation analysis software of SPSS was used to analyze the correlation between Gleason scores of patients with prostatic cancer and quantitative parameters of DCE-MRI. Results: There was no significant difference in the Ve value of quantitative parameter of DCE-MRI between observation group and control group. The parameters of K^trans and Kep in the observation group were significantly higher than those in the control group(t=18.242, t=16.749, P<0.05). The results of ROC curve showed that the area under the curve(AUC) of K^trans and Kep parameters were 0.992 and 0.921, respectively. The differences of AUC between K^trans and Kep parameters were statistically significant(Z=2.658, P<0.05), and both of them were higher than Ve(AUC=0.509). The diagnostic sensitivity and specificity of K^trans were 92.9% and 71.4%, respectively, which were higher than those of Kep(85.6% and 58.6%). The results of SPSS Pearson correlation analysis showed that the Gleason score of prostatic cancer was negatively correlative with K^trans(r=-0.481, P<0.05), and the Gleason score of prostatic cancer had no correlation with Kep and Ve, respectively. Conclusion: The quantitative analysis of DCE-MRI that uses in the diagnosis of prostatic cancer has satisfactory results, and it has a certain correlation with the Gleason score of prostatic cancer and it can provide imaging evidence for clinical practice.