多b值DWI联合T_(2)WI在前列腺疾病良恶性鉴别中的应用价值

Application value of multi-b value DWI combined with T_(2)WI in the differentiation of benign and malignant prostate diseases

目的探讨多b值弥散加权成像(DWI)联合T_(2)加权成像(T_(2)WI)在前列腺疾病良恶性鉴别中的应用价值。方法选取2017年3月至2021年2月收治的60例前列腺特异抗原(PSA)升高的患者作为研究对象,行多b值(600、1000、1500、2000 s/mm^(2))DWI及T_(2)WI,随后在经直肠超声引导下行12针的前列腺饱和穿刺。分析前列腺病理穿刺活检结果;比较前列腺癌和良性前列腺增生患者不同b值下DWI信号强度;分析不同b值DWI联合T_(2)WI对前列腺癌的诊断效能。结果39例患者诊断为前列腺癌,21例患者诊断为良性前列腺增生,1针穿刺阳性1例,2针穿刺阳性7例,3针及以上穿刺阳性31例。不同b值下,前列腺癌患者的DWI信号强度高于良性前列腺增生患者,差异具有统计学意义(P<0.05)。随着b值升高,DWI联合T_(2)WI对前列腺癌的诊断灵敏度升高;b值为2000 s/mm^(2)时,DWI联合T_(2)WI对前列腺癌的诊断灵敏度、特异度最高,为84.62%、80.95%。结论b值为2000 s/mm^(2)时,DWI联合T_(2)WI对前列腺癌的诊断灵敏度、特异度最高,临床应用价值高。

Objective To investigate the application value of multi-b value diffusion weighted imaging(DWI)combined with T_(2) weighted imaging(T_(2)WI)in the differentiation of benign and malignant prostate diseases.Methods Sixty patients with elevated prostate specific antigen(PSA)admitted from March 2017 to February 2021 were selected as the research objects.Multi-b value(600,1000,1500,2000 s/mm^(2))DWI and T_(2)WI were performed,followed by 12 needle prostate saturation puncture under the guidance of transrectal ultrasonography.The result of puncture biopsy pathology of prostate was analyzed;the DWI signal intensity was compared between the patients with prostate cancer and benign prostatic hyperplasia under different b values;and the diagnostic efficacy of different b values DWI combined with T_(2)WI in prostate cancer was analyzed.Results Thirty-nine patients were diagnosed as prostate cancer and 21 patients were diagnosed as benign prostatic hyperplasia,one needle puncture was positive in 1 case,two needle puncture was positive in 7 cases,and three or more needle puncture was positive in 31 cases.Under different b values,the DWI signal intensity of patients with prostate cancer was higher than that of patients with benign prostatic hyperplasia,and the difference was statistically significant(P<0.05).With the increase of b value,the sensitivity of DWI combined with T_(2)WI in the diagnosis of prostate cancer increased.When b value was 2000 s/mm^(2),DWI combined with T_(2)WI had the highest sensitivity and specificity in the diagnosis of prostate cancer,which were 84.62%and 80.95%.Conclusion When b value is 2000 s/mm^(2),DWI combined with T_(2)WI has the highest sensitivity and specificity and high clincal application value in the diagnosis of prostate cancer.