前列腺中央腺体癌磁共振检查ADC值对定性判断及癌灶风险程度的预测价值

ADC Value of Magnetic Resonance Diffusion Weighted Imaging in Qualitative Judgment and Risk Assessment of Central Prostate Gland Cancer

目的分析前列腺中央腺体癌磁共振弥散加权成像检查ADC值对定性判断及癌灶风险程度的预测价值。方法选取医院2017年1月至2019年6月收治的前列腺中央腺体癌患者60例,给予磁共振弥散加权成像检查。比较磁共振弥散加权成像检查结果与病理结果符合情况,判断ADC值对定性判断及癌灶风险程度的预测价值。结果60例患者中15.56%预后不良,84.44%预后较佳。预后不良的患者中复发患者50.00%,转移患者28.57%,死亡患者14.29%,复发伴远处转移7.14%。预后较佳的患者的中央腺体区ADC值低于不良预后患者(P<0.05)。高分化、中分化、低分化符合率及误诊率差异比较有统计学意义(P<0.05)。不同分期符合率及误诊率差异比较有统计学意义(P<0.05)。ADC值在b值为600s/mm;时敏感度为0.711、特异度为0.714、标准误为0.0079、P<0.001、95%CI=0.577~0.0885、曲线下面积=0.731;ADC值在b值为1000s/mm;时敏感度为0.934、特异度为0.643、标准误为0.063、P<0.001、95%CI=0.721~0.969、曲线下面积=0.845。结论前列腺中央腺体癌磁共振检查ADC图呈低信号,术前给予癌磁共振弥散加权成像检查能明确肿瘤分期及分化,提升癌灶风险程度预后价值。

Objective To analyze the ADC value of magnetic resonance diffusion weighted imaging in qualitative judgment and risk assessment of central prostate gland cancer.Methods 60 patients with central prostate gland cancer in our hospital from January 2017 to June 2019 were enrolled,and all patients received the magnetic resonance diffusion weighted imaging.The coincidence of DWI and pathological results was analyzed,and the predictive value of ADC for qualitative judgment and risk assessment was determined.Results Among the 60 patients,15.56%had a poor prognosis and 84.44%had a good prognosis.Among patients with poor prognosis,50.00%had relapse,28.57%had metastasis,14.29%were died,and 7.14%had relapse with distant metastasis.The ADC value of central gland area in patients with better prognosis was lower than that in patients with poor prognosis(P<0.05).The coincidence rate and misdiagnosis rate between DWI and pathological results had significant difference in high differentiation,medium differentiation and low differentiation(P<0.05).When the ADC value was 600 s/mm;,the sensitivity,specificity,standard error and the area under the curve of DWI was0.711,0.714,0.0079,and 0.731(P<0.001,95%CI=0.577-0.0885);When the ADC value was 1000 s/mm;,the sensitivity,specificity,standard error and the area under the curve of DWI was 0.643,0.063,0.643,and 0.063(P<0.001,95%CI=0.721-0.969).Conclusion Magnetic resonance imaging of central prostate cancer shows low signal on ADC.Preoperative DWI of the cancer can clarify the stage and differentiation of the tumor,and improve the prognostic value of the cancer focus risk.