3.0T MR弥散加权成像参数联合在鉴别前列腺癌及Gleason分级中的应用

Application of 3.0T MR Diffusion Weighted Imaging Parameters Combination in Identification of Prostate Cancer and Gleason Grade

目的:分析3.0T MR弥散加权成像(DWI)参数联合在鉴别前列腺癌及Gleason分级中的应用价值。方法:纳入2020年1月—2022年12月萍乡市人民医院收治的90例前列腺疾病患者进行回顾性分析,其中42例前列腺癌患者纳入癌症组,48例良性前列腺增生患者纳入增生组,所有患者均实施磁共振成像(MRI)检查。评估癌症组患者Gleason分级,并根据Gleason分级将其分为高分化组、中低分化组。比较癌症组与增生组DWI参数[信号强度(SI)、表观弥散系数(ADC)、指数表观弥散系数(eADC)],以受试者操作特征(ROC)曲线评估DWI参数联合诊断前列腺癌的价值;比较高分化组与中低分化组患者的DWI参数(SI、ADC、eADC),以ROC曲线评估DWI参数联合诊断高分化前列腺癌的价值。结果:癌症组患者SI、eADC均显著高于增生组,ADC显著低于增生组(P<0.05);ROC曲线中,SI、ADC、eADC联合诊断前列腺癌的曲线下面积(AUC)为0.852,敏感度为78.57%,特异度为79.17%。高分化组SI、eADC均显著低于中低分化组,ADC高于中低分化组(P>0.05);ROC曲线中,SI、ADC、eADC联合诊断高分化前列腺癌的AUC为0.970,敏感度为94.74%,特异度为91.30%。结论:DWI参数联合诊断前列腺癌具有较高价值,可作为临床诊断前列腺癌和判断其分化程度的依据。

Objective:To analyze the application value of 3.0T MR diffusion weighted imaging(DWI)parameters combination in identification of prostate cancer and Gleason grade.Method:A total of 90 patients with prostate diseases admitted to Pingxiang People's Hospital from January 2020 to December 2022 were analyzed retrospectively.Among them,42 patients with prostate cancer were included in the cancer group and 48 patients with benign prostatic hyperplasia were included in the hyperplasia group.All patients underwent magnetic resonance imaging(MRI).Gleason grade of patients in cancer group were evaluated,and the patients were divided into high differentiation group and medium-low differentiation group according to Gleason grade.DWI parameters[signal strength(SI),apparent diffusion coefficient(ADC),exponential apparent diffusion coefficient(eADC)]were compared between cancer group and hyperplasia group.The value of DWI parameters combination in the diagnosis of prostate cancer was evaluated by receiver operating characteristic(ROC)curve.DWI parameters(SI,ADC,eADC)were compared between high differentiation group and medium-low differentiation group.The value of DWI parameters combination in the diagnosis of high differentiation prostate cancer was evaluated by ROC curve.Result:SI and eADC in cancer group were significantly higher than those in hyperplasia group,and ADC was significantly lower than that in hyperplasia group(P<0.05).In the ROC curve,the area under the curve(AUC)of SI,ADC and eADC combination diagnosis of prostate cancer was 0.852,the sensitivity was 78.57%,and the specificity was 79.17%.SI and eADC in high differentiation group were significantly lower than those in medium-low differentiation group,and ADC in high differentiation group was higher than that in medium-low differentiation group(P>0.05).In ROC curve,the AUC of SI,ADC and eADC combination diagnosis of high differentiation prostate cancer was 0.970,the sensitivity was 94.74%,and the specificity was 91.30%.Conclusion:DWI parameters combination have high value in the diagnosis of prostate cancer,and can be used as the basis for clinical diagnosis and differentiation degree of prostate cancer.