不同b值组合的IVIM成像在前列腺癌诊断中的应用价值研究

Study on the Application Value of IVIM Imaging with Different b Value Combinations in the Diagnosis of Prostate Cancer

目的探讨不同b值组合体素内不相干运动(IVIM)成像在前列腺癌(PCa)诊断中的应用价值。方法前瞻性纳入行前列腺IVIM-DWI,且之后经病理确诊为前列腺癌或前列腺增生(BPH)的44例患者作为研究对象。对所有患者的A组(b=0、50、100、150、200、400、600 s/mm^2)和B组(b=0、50、100、150、200、400、600、800、1000、1500、2000 s/mm^2)IVIM-DWI序列分别进行后处理,测得D值、D^*值及f值,比较各参数在PCa与BPH组间、PCa低分组(Gleason评分≤6)与高分组(Gleason评分≥7)间的差异并绘制ROC曲线。分析各参数与Gleason评分的相关性。结果(1)PCa组24例,BPH组20例。A组D值、A组f值及B组D值在两组间的差异有统计学意义(P<0.05)。A组D值、A组f值及B组D值诊断PCa的曲线下面积(AUC)分别为0.917、0.809、0.993。A组D值和f值的AUC没有差异(P>0.05),但二者均低于B组D值的AUC(P<0.05);(2)PCa低分组6例、高分组18例。A、B两组D值在PCa低分组与高分组间差异有统计学意义(P<0.05)。A、B两组D值区分低分组与高分组PCa的AUC分别为0.917、0.926,差异无统计学意义(P>0.05);(3)A、B两组D值与Gleason评分均有相关性,相关系数(r)分别为-0.510、-0.596(P<0.05)。结论低b值(b<200 s/mm^2)为主的IVIM成像与高b值为主的IVIM成像在PCa诊断中均具有一定价值,且二者价值有所不同。

Objective To investigate the value of intra-voxel incoherent motion(IVIM)imaging in the diagnosis of prostate cancer with different b value combinations.Methods We prospectively included 44 patients who received IVIM-DWI of prostate in People’s Hospital of Sichuan Province from November 2018 to May 2019,and who were later diagnosed as prostate cancer(PCa)or benign prostatic hyperplasia(BPH)by pathology.All patients with IVIM-DWI sequence were postprocessed in group A(b=0,50,100,150,200,400,600 s/mm^2)and group b(b=0,50,100,150,200,400,600,800,1000,1500,2000 s/mm^2),respectively.We measured D value,D^*value and f value,calculated the difference of each parameter between PCa and BPH groups,low score(Gleason score≤6)and high score groups(Gleason score≥7).Plotted ROC curves of subjects with statistically significant difference,and analyzed the correlation between each parameter and Gleason score.Results(1)There were 24 cases in PCa group and 20 cases in BPH group.D value,f value of group A,and D value of group B in PCa group were significantly different compared with that in BPH group(P<0.05).The area under curve(AUC)of D value and f value of group A,D value of group B was 0.917,0.809,0.993,respectively.There was no difference in AUC between D value and f value of group A(P>0.05),but both of them were lower than the AUC of D value of group B(P<0.05).(2)There were 6 cases in low score group,and 18 cases in high score group.D value of group A and group B were significantly higher in the low score group than in the high score group(P<0.05).The AUC of D value of group A and group B were 0.917 and 0.926,respectively,and the difference between them had no statistical significance(P>0.05).(3)The D value of group A and group B was correlated with Gleason score,and the correlation coefficient(r)was-0.510 and-0.596 respectively(P<0.05).Conclusion Both IVIM imaging with lower b value(b<200 s/mm^2)and IVIM imaging with higher b value have certain value in PCa diagnosis,and their values are different.