DCE-MRI联合DWI检查在前列腺癌与前列腺增生鉴别诊断中的应用价值

Application Value of DCE-MRI+DWI in the Differential Diagnosis of Prostate Cancer and Benign Prostatic Hyperplasia

目的探究动态对比增强磁共振成像(DCE-MRI)+弥散加权成像(DWI)检查在前列腺癌(PCa)与前列腺增生(BPN)鉴别诊断中的应用价值。方法选取我院由于前列腺特异性抗原(PSA)升高的92例疑似PCa患者(2018年1月至2020年12月)作为研究对象,均经手术病理检查明确病情,比较PCa、BPN患者DWI检查参数[表观扩散系数(ADC值)]、DCE-MRI检查参数[容量转移常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积比(Ve)],比较DCE-MRI、DWI及DCE-MRI+DWI检查的诊断价值。结果92例疑似PCa患者经手术病理检查证实49例PCa,43例BPN;PCa患者ADC值低于BPN患者,Ktrans、Kep、Ve高于BPN患者(P<0.05);DCE-MRI+DWI检查诊断PCa的AUC值大于DCE-MRI、DWI检查。结论DCE-MRI、DWI检查对PCa的诊断均有一定应用价值,将两者联合应用AUC值明显提升,有助于及时发现PCa,指导临床治疗。

Objective To explore the application value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)+diffusion-weighted imaging(DWI)in the differential diagnosis of prostate cancer(PCA)and benign prostatic hyperplasia(BPN).Methods 92 cases of suspected PCA patients(January 2018 to December 2020)with elevated prostate specific antigen(PSA)in our hospital were selected as the research objects.The disease condition was confirmed by surgical and pathological examination.The DWI examination parameters[apparent diffusion coefficient(ADC)],DCE-MRI examination parameters[volume transfer constant(Ktrans),rate constant(kep)]of PCA and BPN patients were compared The diagnostic value of DCE-MRI,DWI and DCE-MRI+DWI was compared.Results Among 92 patients with suspected PCA,49 cases were PCA and 43 cases were BPN;ADC value of PCA patients was lower than that of BPN patients,Ktrans,kep,ve were higher than that of BPN patients(P<0.05);The AUC value of DCE-MRI+DWI in the diagnosis of PCA was higher than that of DCE-MRI and DWI.Conclusion DCE-MRI and DWI have certain application value in the diagnosis of PCA.The AUC value of DCE-MRI and DWI combined with DCE-MRI is significantly increased,which is helpful to discover PCA in time and guide clinical treatment.