磁共振扩散峰度成像与Gleason评分的相关性研究

The correlation between magnetic resonance DKI and Gleason score

目的探讨扩散峰度成像(DKI)各定量参数与前列腺癌Gleason评分的相关性。方法经病理确诊为前列腺癌并行DKI序列扫描(b值为0、700、1400、2100 s/mm^(2))的41例患者,按Gleason病理评分(GS)系统分为低级别组4例(GS<7),中等级别组17例(GS=7)和高级别组20例(GS>7),比较不同组间的平均扩散峰度(K值)、平均扩散系数(D值)及ADC值的差异,分析各参数的诊断效能。结果低级别组与中等级别组比较,仅D值差异有统计学意义(P=0.026),两组与高级别组各参数比较,差异均有统计学意义(P<0.05)。ADC值和D值与GS评分呈负相关(r分别为-0.501、-0.600,P<0.05);K值与GS评分呈正相关(r=0.694,P=0.000)。K值鉴别诊断中低级别组与高级别组的ROC曲线下面积(AUC)为0.878,特异性为94.7%,敏感性为77.3%,分界点为0.132×10^(-3)。结论DKI定量参数K值对高级别前列腺癌的预测具有一定的潜在的临床应用价值。

Objective To investigate the relationship between the quantitative parameters of magnetic resonance diffusion kurtosis imaging(DKI)and different Gleason score(GS)of prostate cancer.Methods Forty-one patients who were pathologically confirmed as prostate cancer underwent DKI scan(b values including 0,700,1,400 and 2,100 s/mm^(2)).The patients were classified into low-grade group(GS<7,n=4),medium-grade group(GS=7,n=17),and high-grade group(GS>7,n=20)according to the GS.The differences of mean diffusion kurtosis(K value),mean diffusion coefficient(D value),and ADC value of different groups were compared.The diagnostic efficiency of each parameter was analyzed.Results Only the difference in D value was statistically significant(P=0.026)when the low-grade group was compared with the medium-grade group.The difference was statistically significant(P<0.05)when comparing all parameters of the low-grade group and the medium-grade group with those of the high-grade group.ADC and D values were negatively correlated with GS scores(r=-0.501 and-0.600,respectively,P<0.05).However,K value was positively correlated with GS scores(r=0.694,P=0.000).The ROC curve analysis showed that the K value had the greatest diagnostic efficacy in low-medium grade groups and high-grade group(AUC=0.878)with a specificity of 94.7%,a sensitivity of 77.3%and a cut-off point of 0.132×10^(-3).Conclusion The DKI quantitative parameter K value has some potential clinical application value for the prediction of high-grade prostate cancer.