1.5TMRI不同b值DWI技术对中央移行带早期前列腺癌诊断的探讨

The Study of the Diagnosis of Early Prostate Cancer in Central Transitional Zone by DWI with Different b Values on 1.5T MRI

目的探讨1.5T磁共振三种不同b值弥散加权成像技术在早期中央移行带前列腺癌(PCA)诊断中的应用。方法回顾性分析我院34例实验检查发现PSA明显增高,经MRI扫描高度怀疑早期中央移行带前列腺癌病例,所有病例经穿刺或手术病理证实为早期中央移行带前列腺癌病例进行分析,所有分析对象采用T1WI、T2WI常规扫描序列及DWI扫描,DWI扫描b值选用800s/mm^(2)、1500s/mm^(2)、2500s/mm^(2);后处理产生表观弥散系数ADC,结合参考MIS图像。对其结果进行分析。结果34例被检者中,b值选择800s/mm^(2)时,敏感性为54.5%(6/11),特异性为68.2%(16/23),漏诊率为45.5%(5/11),误诊率为31.8%(7/23);b值选择1500s/mm^(2)时,敏感性为83%(20/24),特异性为70%(7/10),漏诊率为17%(4/24),误诊率为30%(4/24);b值选择2500s/mm^(2)时,敏感性为68.4%(13/19),特异性为60%(9/15),漏诊率为31.5%(6/19),误诊率为40%(6/15);表观弥散系数ADC值是随着b值的增加而下降,信号强度不同;MIS图示表现为流出型。结论1.5T磁共振诊断早期中央移行带前列腺癌(PCA)弥散成像,选用b值为1500s/mm^(2)时,能较好的反映PCA信号的变化,敏感性、特异性较高,漏诊率、误诊率较低,弥散成像选用b值为2500s/mm^(2)时,虽然敏感性还高,由于信号对比越明显,图像信噪比越低,存在着假阳性,漏诊率、误诊率较高。结合MIS图像能提高中央移行带早期PCA的确诊率,具有重要临床应用价值。

Objective To investigate the application of 1.5T MR Diffusion-weighted imaging with different b values in the diagnosis of early central transitional zone of prostate cancer(PCA).Methods A total of 34 cases showed a significant increase in PAS.Early cases of central transitional zone prostate cancer were highly suspected by MRI.All cases were confirmed by biopsy or surgical pathology as early central transitional zone prostate cancer.All patients were scanned using T1WI,T2WI routine scanning sequences and DWI scanning.The b value of DWI scan was selected 800s/mm^(2)、1500s/mm^(2)、2500s/mm^(2)and post-processing produces an apparent dispersion coefficient ADC.Analyze the results Combine the reference MIS image.Results Among the 34 cases,when b value was selected as 800s/mm^(2),the sensitivity 54.5%(6/11);specificity 68.2%(16/23);missed diagnosis rate 45.5%(5/11);misdiagnosis rate 31.8%(7/23),when b value was selected as 1500s/mm^(2),the Sensitivity 83%(20/24);specificity 70%(7/10);missed diagnosis rate 17%(4/24);misdiagnosis rate 30%(4/24).when b value was selected as 2500s/mm^(2),the Sensitivity was 68.4%(13/19)specificity was 60%(9/15)missed diagnosis rate was 31.5%(6/19)misdiagnosis rate was 40%(6/15),The ADC value of apparent dispersion coefficient decreases with the increase of b value.The image shows that flow type.Conculsion the early central transitional zone prostate cancer(PCA)can be diagnosis on 1.5T magnetic resonance imaging,and it has important clinical application value.