MRI弥散加权成像在前列腺增生和前列腺癌诊断鉴别中的应用

Application of MRI Diffusion-weighted Imaging in the Differential Diagnosis of Benign Prostatic Hyperplasia and Prostate

目的分析MRI弥散加权成像磁共振弥散加权成像(DWI)在前列腺增生和前列腺癌诊断鉴别中的应用。方法将2017年1月~2019年1月在本院经手术或穿刺活检病理确诊的前列腺病变患者病变类型对应前列腺增生组、前列腺癌组;另筛选同期于本院行健康体检的30名志愿者作为对照组。比较三组MRI-DWI参数,并绘制受试者工作特征(ROC)曲线分析MRI-DWI参数对前列腺病变、前列腺癌的诊断鉴别价值。结果与对照组比较,前列腺癌组D、ADC显著较低,f显著较高(P<0.5);与前列腺增生组比较,前列腺癌组D、ADC显著较低,D~*、f显著较高(P<0.05);但前列腺增生组、对照组比较差异无统计学意义(P>0.05);单一MRI-DWI参数诊断前列腺疾病时ADC曲线下面积值(AUC)最高,以1.001×10^-3mm^2/s为cut-off,灵敏度为59.00%、特异度96.70%;联合诊断时特异性上升至100.00%;单一参数诊断前列腺癌时同样以ADCAUC值最高,1.269×10^-3mm^2/s为cut-off,其预测前列腺癌的灵敏度为100.00%、特异度高达86.10%;与联合诊断一致。结论MRI-DWI扫描在前列腺增生及前列腺癌鉴别诊断有较高效能,值得临床推介。

Objective To analyze the application of MRI diffusion-weighted imaging(DWI)in the differential diagnosis of benign prostatic hyperplasia and prostate cancer.Methods The patients with prostatic lesions diagnosed by surgery or biopsy in the hospital from January 2017 to January 2019 were divided into benign prostatic hyperplasia group and prostate cancer group by lesion types.Another 30 volunteers who were in the hospital for physical examination at the same time were selected as control group.The MRIDWI parameters were compared among the three groups,and the receiver operating characteristic(ROC)curve was analyzed to analyze the differential diagnostic value of MRI-DWI parameters in the diagnosis of prostate lesions and prostate cancer.Results Compared with control group,the D and ADC were significantly lower in prostate cancer group while the f was significantly higher(P<0.5).Compared with benign prostatic hyperplasia group,the D and ADC were significantly lower in prostate cancer group while the D~*and f were significantly higher(P<0.05).However,there were no significant differences between benign prostatic hyperplasia group and control group(P>0.05).The area under the ADC curve(AUC)of single MRI-DWI parameter was the highest in the diagnosis of prostate lesions,and the sensitivity and specificity were 59.00%and 96.70%by taking 1.001×10^-3 mm^2/s as cut-off.Specificity was increased to 100.00%in combination diagnosis.The AUC value of ADC single parameter was the highest in the diagnosis of prostate cancer,and the sensitivity of prostate cancer prediction was 100.00%and the specificity was as high as 86.10%by taking 1.269×10^-3 mm^2/s as cut-off.The above was consistent with the combination diagnosis.Conclusion MRI-DWI scan has high efficacy in the differential diagnosis of prostatic hyperplasia and prostate cancer,which is worthy of clinical recommendation.