前列腺癌神经周围扩散的多模态影像学诊断的临床价值

Clinical values of multimodal imaging in diagnosis of peripheral nerve diffusion in prostate cancer

目的探究功能磁共振对前列腺癌早期诊断及其联合应用的价值,为临床肿瘤良恶性鉴别诊断以及预后评估提供可靠依据。方法对前列腺癌患者功能磁共振成像,包括弥散加权成像、T2*W首过灌注成像(PWI-T2*WI)、T1WI动态增强成像(DCE-T1WI)和磁共振波谱成像,获取病变的血流动力学和生化代谢等生物学信息,并联合应用相关参数对前列腺病灶进行术前评估,对患者前列腺病灶及周围组织形态进行观察,同时观察患者前列腺的形态,直径大小以及恶化程度,同时进行病理学检查。结果前列腺癌神经周围扩散的多模态影像学检查结果与病理结果以及穿刺检查结果间比较,差异有统计学意义(P<0.05);多模态影像学检查能够检测出全部患者的神经周围扩散的症状,而病理检查检出结果则够不全面,且多模态影像学检查灵敏度、特异度、阳性预测值、阴性预测值和诊断准确率均较病理检查诊断结果高,差异有统计学意义(P<0.05)。结论前列腺癌神经周围扩散的多模态影像学诊断的临床价值较高。

Objective To explore the value of functional magnetic resonance imaging(FMRI)in early diagnosis of prostate cancer and its values of combined application so as to provide a reliable basis for the differential diagnosis of benign and malignant tumors and prognosis evaluation.Methods Patients with prostate cancer were given functional magnetic resonance imaging(FMRI),including diffusion-weighted imaging,T2*-weighted first-pass perfusion imaging(PWI-T2*WI),dynamic contrast-enhanced T1-weighted imaging(DCE-T1WI)and magnetic resonance spectroscopy(MRS)to obtain biological information such as hemodynamics and biochemical metabolism of the lesion.Combined application of relevant parameters,preoperative evaluation of prostate lesions was given and prostate lesions and surrounding tissue morphology were observed.At the same time,morphology,diameter and deterioration degree of prostate of patients were observed,and pathological examination was performed.Results The results of multimodal imaging findings of peripheral nerve diffusion of prostate cancer were compared with pathological results and puncture results,and the difference was statistically significant(P<0.05).Multimodal imaging can detect symptoms of peripheral nerve diffusion in all patients,while pathological findings were not comprehensive enough.The sensitivity,specificity,positi ve predictive value,negative predictive value and diagnostic accuracy of multimodal imaging examination were higher than those of pathological examination,and the difference was statistically significant(P<0.05).Conclusion Multimodal imaging in diagnosis of peripheral nerve diffusion in prostate cancer is of high clinical value.