高场强MRI在前列腺良恶性病变诊断中的应用效果

Application of High Field MRI in the Diagnosis of Benign and Malignant Prostate Diseases

目的分析高场强磁共振成像(high field strength magnetic resonance imaging,MRI)对前列腺良恶性病变的鉴别诊断价值。方法选取2016年1月—2021年12月盐城市第三人民医院影像科收治的疑似前列腺病变患者60例,均以高场强MRI检查,以手术穿刺活检病理诊断结果为金标准,分析高场强MRI诊断效能及影像学特征。结果手术病理确诊30例为良性前列腺增生(阴性)、30例为前列腺癌(阳性)。高场强MRI诊断准确度为95.00%,敏感度为93.33%,特异度为96.67%,阳性预测值为96.55%,阴性预测值为93.55%。经一致性系数分析,高场强与MRI诊断一致性为0.900,一致性良好。前列腺增生:前列腺体积弥漫性增大,T_(2)WI显示前列腺中央叶明显增大,信号不均匀,呈类圆形高信号/低信号,外周带受压变窄。前列腺癌:癌组织呈弥漫性浸润性生长,T_(2)WI移行带呈低信号,边界模糊,病变位于包膜内或突破包膜、侵犯精囊腺或血管神经束,或合并淋巴结肿大、骨盆骨转移。结论高场强MRI在前列腺良恶性病变鉴别诊断中的准确性和可靠性较高,具有推广应用价值。

Objective To analyze the value of high field strength magnetic resonance imaging(MRI)in the differential diagnosis of benign and malignant prostate diseases.Methods 60 patients with suspected prostate lesions admitted to the Imaging Department of Yancheng Third People's Hospital from January 2016 to December 2021 were selected,all of whom underwent high field MRI examination.The pathological diagnosis results of surgical puncture biopsy were used as the gold standard,and the diagnostic efficacy and imaging characteristics of high field MRI were analyzed.Results Pathological examination results:30 of the 60 patients were diagnosed with benign prostate hyperplasia(negative)and 30 were diagnosed with prostate cancer(positive).The diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of high field strength MRI were 95.00%,93.33%,96.67%,96.55% and 93.55% respectively.By consistency coefficient analysis,the consistency between high field strength and MRI diagnosis was 0.900,with good consistency.Benign prostatic hyperplasia:The volume of the prostate increased diffusely.T_(2)WI showed that the central lobe of the prostate increased significantly,the signal was uneven,showing a round-like high signal/low signal,and the peripheral zone was narrowed.Prostate cancer:the cancer tissue showed diffuse invasive growth,T_(2)WI transition zone showed low signal,blurred boundary,the lesion was located in the capsule or broke through the capsule,invaded the seminal vesicle gland or vascular nerve bundle,or combined with lymph node enlargement and pelvic bone metastasis.Conclusion The accuracy and reliability of high field strength MRI in the differential diagnosis of benign and malignant prostate diseases are high,and the specific application value is to popularize.