摘要
目的探讨超高b值扩散加权成像（DWI）对前列腺癌的诊断效能。方法收集2014年6月1日至2015年5月30日解放军总医院73例患者，行前列腺T2WI、常规DWI（b值为1 000s/mm2）和超高b值DWI（b值分别为2000、3000s/mm2）检查。根据评分诊断前列腺病变，以穿刺病理结果为金标准，计算不同影像检查方法诊断前列腺癌的灵敏度、特异度、阳性预测值及阴性预测值。比较超高b值DWI和常规DWI诊断前列腺癌的灵敏度和特异度，并分析受试者工作特征（ROC）曲线下面积（AUC）。结果2 000、3000 s/mm2超高b值DWI诊断前列腺外周带癌的灵敏度分别为88.1%和92.5%，特异度分别为53.1%和68.8%，均高于常规DWI（均P〈0.000 1）。2000、3000s/mm2超高b值DWI诊断前列腺移行区癌的灵敏度分别为80.0%和88.0%，特异度分别为52.9%和88.2%，均高于常规DWI（均P〈0.000 1）。2000、3000 s/mm2超高b值DWI间诊断前列腺外周带和移行区癌的灵敏度差异无统计学意义（均P〉0.05）；3000 s/mm2超高b值DWI诊断移行区前列腺癌的特异度高于2000 s/mm2（P〈0.000 1）。3000 s/mm2超高b值DWI诊断的阳性预测值及阴性预测值均最高，外周带和移行区阳性预测值分别为86.1%和91.7%，阴性预测值分别为81.5%和83.3%。T2WI、常规DWI、超高b值DWI诊断前列腺外周带癌的AUC分别为0.591、0.553、0.698和0.806，诊断移行区癌分别为0.693、0.506、0.665和0.881，3000 s/mm2超高b值DWI的AUC均最大。结论超高b值DWI是一种较为准确和可靠的前列腺癌诊断方法。
ObjectiveTo explore the value of ultra-high b-value diffusion-weighted imaging （DWI） in diagnosis of prostate cancer.MethodsAccording to inclusion and exclusion criteria, 73 consecutive examinees in Chinese PLA General Hospital from June 2014 to May 2015 were screened. Written informed consent was obtained from all patients. T2WI, conventional DWI with b-value of 1 000 s/mm2 and ultra-high b-value DWI with 2 000 s/mm2 and 3 000 s/mm2 were performed in each examinee. Images were interpreted and were corresponding to histological results conducted by ultrasound guided prostate systematic biopsy. Reference biopsy as the gold standard, the sensitivity, specificity, positive predictive value （PPV） and negative predictive value （NPV） were calculated for each image. Sensitivity and specificity differences between ultra-high b-value DWI and conventional DWI were analyzed. The areas under the curves （AUCs） between ultra-high b-value DWI and other modalities were compared.ResultsThe sensitivity and specificity for ultra-high b-value DWI were 92.5% and 68.8% with b-value of 3 000 s/mm2, and they were 88.1% and 53.1% for 2 000 s/mm2 in peripheral zone. The sensitivity and specificity for ultra-high b-value DWI were 88.0% and 88.2% with a b-value of 3 000 s/mm2, and they were 80.0% and 52.9% for 2 000 s/mm2 in transition zone. The values of sensitivity for ultra-high b-value DWI were significantly higher than those for conventional DWI both in peripheral zone and transition zone （all P 〈0.000 1）. The detection of lesions was comparable with ultra-high b-value DWI at 2 000 s/mm2 and 3 000 s/mm2 in peripheral zone （P 〉 0.05）, whereas the value of specificity for 3 000 s/mm2 were significantly higher than that for 2 000 s/mm2 in transition zone （P 〈0.000 1）. PPV and NPV for 3 000 s/mm2 were significantly higher than those for the other three modalities both in peripheral zone （86.1% and 81.5%） and transition zone （91.7% and 83.3%）. In peripheral zone, the AUCs were 0.591, 0.553, 0.698 and 0.806 in T2WI, conventional DWI and ultra-high b-value DWI at 2 000 s/mm2 and 3 000 s/mm2 respectively, for the diagnosis of transition zone cancer were 0.693, 0.506, 0.665 and 0.881 respectively, and the AUCs for the ultra-high b-value with 3 000 s/mm2 were the largest.ConclusionUltra-high b-value DWI is an accurate and reliable method in the diagnosis of prostate cancer.
作者
张琨
张瑞平
郭勇
张晓晶
申艳光
钟燕
王海屹
叶慧义
Zhang Kun;Zhang Ruiping;Guo Yong;Zhang Xiaojing;Shen Yanguang;Zhong Yan;Wang Haiyi;Ye Huiyi(Department of Radiology, Navy General Hospital, Beijing 100048, China;Department of MRI and CT, Shanxi Provincial Cancer Hospital, Taiyuan 030013, Chin;Department of Radiology, Chinese PLA General Hospital, Beijing 100853, China)
出处
《肿瘤研究与临床》
CAS
2018年第5期298-302,共5页
Cancer Research and Clinic
基金
军队保健专项科研课题（14BJZ02）
关键词
前列腺肿瘤
磁共振成像
超高b值扩散加权成像
Prostatic neoplasms
Magnetic resonance imaging
Ultra-high b-value diffusion-weighted imaging
