基于高b值DWI的容积ROI直方图鉴别中央腺体前列腺癌与良性前列腺增生的价值

The volumetric ROI histogram based on DWI with high b value in differentiating prostatic carcinoma from benign prostatic hyperplasia in central gland

目的:探讨高b值磁共振弥散加权成像(diffusion-weighted imaging,DWI)的表观弥散系数(apparent diffusion coefficient,ADC)的容积感兴趣区(volumetric region of interest,vROI)直方图鉴别中央腺体(central gland,CG)前列腺癌(prostatic carcinoma,PCa)与良性前列腺增生(benign prostatic hyperplasia,BPH)的价值。方法:回顾并分析2017年3月-2021年7月于辽阳辽化医院经前列腺标准b值(b=800 s/mm^(2))和高b值(b=1500 s/mm^(2))DWI扫描且经病理学检查证实的59例PCa患者(62个病灶)和80例BPH患者(80个病灶)。在美国GE公司的AW4.6工作站上对标准b值和高b值的DWI图进行后处理,分别获得ADC_(800)和ADC_(1500)。利用Fire Voxel软件,分别在ADC_(800)和ADC_(1500)图像的每一层面沿着病灶边缘勾画ROI,再将这些ROI融合成vROI。随后对vROI进行直方图分析,获得直方图参数ADC_(800-mean、std、min、1th、5th、10th、25th、50th、75th、90th、95th、max、ske、kur)和ADC_(1500-mean、std、min、1th、5th、10th、25th、50th、75th、90th、95th、max、ske、kur)。采用组内相关系数(interclass correlation coefficient,ICC)检验2名医师所测结果的一致性;采用独立样本t检验或Mann-Whitney U检验比较各参数的差异;绘制受试者工作特征(receiver operating characteristic,ROC)曲线,评价诊断效能,采用DeLong检验比较两种b值所得参数的曲线下面积(area under curve,AUC)的差异。结果:2名医师测得结果一致性良好(ICC>0.75);PCa的ADC_(800-min、5th、10th、25th)、ADC_(1500-mean、min、5th、10th、25th、50th)低于BPH;ADC_(1500-mean、min、5th、10th)的AUC高于相应的直方图参数ADC_(800-mean、min、5th、10th),差异有统计学意义(P<0.05)。结论:基于高b值的DWI的vROI直方图能够鉴别发生于CG的PCa和BPH,其诊断效能高于基于标准b值所得结果。

Objective:To explore the volumetric region of interest(vROI)histogram of apparent diffusion coefficient(ADC)of diffusion-weighted imaging(DWI)with high b value to differentiate prostatic carcinoma(PCa)from benign prostatic hyperplasia(BPH)in central gland(CG).Methods:A total of 59 PCa patients(62 lesions)and 80 BPH patients(80 lesions)confirmed by pathology in CG were retrospectively analyzed,who preoperatively underwent DWI scanning with standard b value(b=800 s/mm^(2))and high b value(b=1500 s/mm^(2))in Liaoyang Liaohua Hospital from March 2017 to July 2021.In GE AW4.6 workstation,the DWI(b=800 s/mm^(2) and b=1500 s/mm^(2))were post-processed to obtain the ADC_(800) and ADC_(1500).In Fire Voxel software,the ROIs were drawn along the edge of lesion on each layer of ADC_(800) and ADC_(1500) image and merged into a vROI respectively.The histogram analysis of vROI was performed to obtain parameters,which including ADC_(800-mean、std、min、1th、5th、10th、25th、50th、75th、90th、95th、max、ske、kur) and ADC_(1500-mean、std、min、1th、5th、10th、25th、50th、75th、90th、95th、max、ske、kur).Interclass correlation coefficient(ICC)test was used to evaluate the consistency of measurement results by two radiologists.Independent sample t test or Mann-Whitney U test was used to compare the differences between the two groups.The receiver operating characteristic(ROC)curves were drawn,which were followed by the diagnostic performance analysis.The area under curves(AUCs)were compared between histogram parameters of vROI derived from two different b values by using DeLong test.Results:The results between two radiologists were consistent(ICC>0.75).The ADC_(800-min、5th、10th、25th) and ADC_(1500-mean、min、5th、10th、25th、50th) of PCa group were lower than those of BPH group(P<0.05).The AUC value of ADC_(1500-mena、min、5th、10th) was higher than that of ADC_(1500-mena、min、5th、10th)(P<0.05).Conclusion:vROI histogram based on DWI with high b value can differentiate PCa from in CG,and its diagnostic efficiency was higher than standard b value.