3.0T磁共振Resolve-Dwi技术联合Tissue4D灌注成像定量对职业暴露条件下前列腺癌的评估

Clinical study of quantitative analysis based on Resolve-Dwi Technique and DCE-MRI Tissue 4D perfusion imaging in the diagnosis of prostate cancer

目的职业暴露条件下前列腺疾病患者利用3.0T磁共振高分辨扩散加权成像(Resolve-Dwi)的表观扩散系数及Tissue 4D灌注成像生成的定量参数,探讨职业暴露条件下前列腺癌的诊断效能与临床应用价值。方法回顾性分析本院2018年2月至2020年12月行MRI检查并经病理证实为前列腺疾病的44例患者相关资料,患者均为包装工,平均年龄为(66.1±7.4)岁,以前列腺癌的32例患者为前列腺癌组,前列腺增生症的12例患者为前列腺增生组。分析比较两组间Resolve-Dwi自动生成的表观扩散系数值(ADC)及定量参数容积转运常数(K^(trans)、速率常数(K_(ep))、血管外细胞外容积分数(V_(e))值对前列腺癌的诊断及鉴别诊断价值,评估其与病理Gleason评分系统的相关性。通过评价磁共振Resolve-Dwi技术及Tissue 4D灌注成像的分析结果得出诊断效能。结果前列腺癌组和前列腺增生组ADC值分别为(0.96±0.14)×10^(-3)mm^(2)/s和(1.86±0.47)×10^(-3)mm^(2)/s,两组比较,差异有统计学意义(t=-9.79,P=0.000)。比较分析两组间定量参数,前列腺癌组K^(trans)、K_(ep)值较前列腺增生组高,差异有统计学意义(t=3.07,P=0.004;t=3.11,P=0.003),V_(e)值比较,差异无统计学意义(t=-0.13,P=0.847)。前列腺癌组K^(trans)、K_(ep),V_(e)值与Gleason评分无明显相关性。Resolve-Dwi技术联合Tissue 4D灌注成像的诊断灵敏度和特异度分别为94.2%和89.0%,均高于单独使用Resolve-Dwi(87.5%和75.7%)及Tissue 4D灌注成像(88.1%和81.0%)。Resolve-Dwi技术联合Tissue 4D灌注成像比分别单独使用诊断前列腺癌的灵敏度和特异度高。结论Resolve-Dwi技术联合Tissue 4D灌注成像对评估包装工前列腺疾病的良恶性具有价值,尤其是可定量评估肿瘤的生长和侵袭过程密切相关的微血管密度,为包装工前列腺疾病的诊治及预后评估提供依据。

Objective To explore the efficacy and clinical value of quantitative analysis with Resolve-Dwi-ADC and DCE-MRI Tissue 4 D perfusion imaging in the diagnosis of prostate cancer. Methods The data of 44 cases of prostate disease confirmed by pathology and MRI examined were analyzed retrospectively between February 2018 to December 2020. All the patients were packers with an average age of(66.1±7.4)years.Thirty two patients with prostate cancer were taken as the prostate cancer group and 12 patients with benign prostatic hyperplasia were taken as the benign prostatic hyperplasia group.Quantitative parameters including ADC value、K^(trans)、K_(ep) and V_(e) value on Resolve-Dwi and DCE-MRI Tissue 4 D perfusion imaging were analyzed and compared between the two groups. The correlation between K^(trans)、K_(ep)、 V_(e) value and Gleason score of prostate cancer was analyzed. The diagnostic efficacy was obtained by evaluating the analysis results of magnetic resonance Resolve-Dwi-ADC and DCE-MRI Tissue 4 D perfusion imaging. Results The average ADC values of prostate cancer group and benign prostatic hyperplasia group were(0.96±0.14)×10^(-3)mm^(2)/s、(1.86±0.47)×10^(-3)mm^(2)/s, and the difference was statistically significant(t=-9.79,P=0.000).There were significant differences in K^(trans) and K_(ep) between the two groups(t=3.07,P=0.004;t=3.11,P=0.003),and no significant difference was found in V_(e)(t=-0.13,P=0.847). Meanwhile, K^(trans),K_(ep),and V_(e) values were not relevant with Gleason score.The sensitivity, specificity and accuracy of Resolve-Dwi combined with DCE-MRI Tissue 4 D perfusion imaging in diagnosis of prostate cancer were 94.2% and 89.0%,which were higher than that of simple Resolve-Dwi(87.5% and 75.7%)and DCE-MRI Tissue 4 D perfusion imaging(88.1% and 81.0%). Conclusions The combined application of Resolve-Dwi and DCE-MRI Tissue 4 D perfusion imaging has good clinical application value and may help in differential diagnosis of prostate cancer, and itis helpful to improve the diagnostic efficiency of benign and malignantprostate disease.