1.5T磁共振多b值DWI及ADC值定量分析在前列腺癌与前列腺增生诊断的价值研究

Value of 1.5T Magnetic Resonance Imaging Multi-B Value DWI and ADC Value Quantitative Analysis in the Diagnosis of Prostate Cancer and Benign Prostatic Hyperplasia

目的探讨1.5T磁共振(MRI)多b值扩散加权成像(DWI)及表观扩散系数(ADC)值定量分析在前列腺癌(PCa)与前列腺增生(BPH)诊断中的价值。方法将我院经病理活检证实为前列腺疾病的232例患者作为研究对象,其中PCa者100例,BPH者132例。所有患者均进行常规1.5TMRI扫描和多b值DWI检查,比较不同b值两组ADC值。结果PCa患者DWI上可见局灶性(或弥漫性)高信号,ADC图显示有对比周围组织较低的低值区;BPH患者DWI显示前列腺增生结节,呈高或稍高信号,ADC图显示有对比周围组织较低的低值区。不同b值下,PCa组ADC值均存在差异,其中b值=1500s/mm^2时的ADC值小于b值=800、1000s/mm^2时的ADC值(P<0.05),b值=1000s/mm^2时的ADC值小于b值=800s/mm^2时的ADC值(P<0.05);b值=800、1000、1500s/mm^2时,PCa组ADC值均低于BPH组(P<0.05)。ROC曲线分析显示当b值=1500s/mm^2时,ADC值诊断效果最佳,所得阈值为1.013×10^-3mm^2/s,敏感度为96.00%,特异度为93.94%。结论1.5TMRI多b值DWI及其ADC值定量分析可有效鉴别PCa和BPH,可在临床推广应用。

Objective To explore the value of 1.5T magnetic resonance imaging(MRI)multi-b diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)quantitative analysis in the diagnosis of prostate cancer(PCa)and benign prostatic hyperplasia(BPH).Methods 232 patients with prostatic diseases confirmed by pathological biopsy in our hospital were set for the study,including 100 cases of PCa and 132 cases of BPH.All patients were given routine 1.5T MRI scan and multi-b value DWI.ADC values under different b values were compared between the two groups.Results In PCa patients,focal(or diffuse)high signal was seen on DWI,and a low-value area with contrast to surrounding tissues was shown by ADC.In BPH patients,prostatic hyperplasia nodules and high or slightly high signal were showed by DWI,and a low-value area with contrast to surrounding tissues was displayed by ADC.Under different b values,there were differences in ADC values in PCa group,the ADC value of b value=1500 s/mm^2 was smaller than that of b value=800,1000 s/mm^2(P<0.05),and the ADC value of b value=1000 s/mm^2 was smaller than that of b value=800 s/mm^2(P<0.05).When b value=800,1000,1500 s/mm^2,the ADC values in PCa group were lower than those in BPH group(P<0.05).The ROC curves showed the diagnostic effect of ADC value was the best when the b value was 1500 s/mm^2,and the threshold,sensitivity and specificity were 1.013×10^-3 mm^2/s,96.00%and 93.94%.Conclusion 1.5T MRI multi-b value DWI and its ADC value quantitative analysis can effectively identify PCa and BPH,which can be applied and promoted in clinical practice.