多B值DWI鉴别诊断血精性精囊炎与前列腺癌伴精囊浸润

Differential Diagnosis of Hematospermic Seminal Vesiculitis and Prostate Cancer with Seminal Vesicle Infiltration Using Multi B-Value DWI

目的:比较弥散加权成像(DWI)在血精性精囊炎(HSV)和前列腺癌(PCa)伴精囊浸润(SVI)鉴别诊断中的应用价值。方法:本研究共纳入68例患者,HSV 31例,PCa伴SVI 37例。所有患者行多B值DWI磁共振成像(MRI)检查,B值分别设为0、100、200、400、800、1 200和1 600 s/mm^(2)。表观弥散系数(ADC)的重建采用双B值指数模型,分别采用B值为0 s/mm^(2)的DWI图与其他不同B值的DWI图重建,测量病灶的ADC值。最后统计分析DWI信号强度和ADC值。结果:37例PCa伴SVI的转移灶在DWI图上均表现为高信号,且高信号范围随B值的增大而缩小;HSV组病灶在DWI图上呈高信号的例数随B值增大而逐渐减少,当B值≥800 s/mm^(2)时,两组患者具有统计学差异(P<0.05)。HSV组不同B值的ADC值均高于PCa伴SVI组(P<0.05),且B值越大差异越明显。结论:通过测量病灶的ADC值和观察DWI信号强度,多B值DWI可用于HSV与PCa伴SVI的诊断和鉴别诊断。

Objective:To compare the application value of diffusion-weighted imaging(DWI)in the differential diagnosis of hematospermatic seminal vesiculitis(HSV)and prostate cancer(PCa)with seminal vesicle invasion(SVI).Methods:A total of 68 patients were included in this study,including 31 cases of HSV and 37 cases of PCa with SVI.All patients underwent multi-B-value DWI magnetic resonance imaging(MRI)with B-values set to 0,100,200,400,800,1200,and 1600 s/mm^(2).The apparent diffusion coefficient(ADC)was reconstructed using a dual-B-value exponential model,with DWI images at B-value of 0 s/mm^(2) and other different B-values used for reconstruction,and the ADC values of the lesions were measured.Finally,the DWI signal intensity and ADC values were statistically analyzed.Results:The metastatic lesions in the 37 cases of PCa with SVI showed high signal on DWI images,and the range of high signal decreased as the B-value increased.The number of lesions with high signal in the HSV group gradually decreased as the Bvalue increased,and when the B-value≥800 s/mm^(2),there was a statistical difference between the two groups(P<0.05).The ADC values of different B-values in the HSV group were higher than those in the PCa with SVI group(P<0.05),and the larger the B-value,the more obvious the difference.Conclusion:By measuring the ADC values of lesions and observing the DWI signal intensity,multi-B-value DWI can be used for the diagnosis and differential diagnosis of HSV and PCa with SVI.