摘要
目的探究动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)与扩散加权成像(diffusion-weighted imaging,DWI)在前列腺中央腺体癌(central gland prostate cancer,CGPCa)诊断中的应用价值。材料与方法回顾性分析2017年1月至2020年1月经穿刺活检或手术病理证实的113例前列腺疾病患者的临床资料,根据疾病类型分为CGPCa组(51例)和腺体增生组(benign prostatic hyperplasia,BPH;62例)。所有患者均接受常规MRI、DCE-MRI及DWI扫描。分析两组患者MR图像特征,比较DCE-MRI定量参数、表观扩散系数(apparent diffusion coefficient,ADC)值在两组患者及不同病变程度CGPCa患者中的差异:采用受试者工作特征(receiver operating characteristic,ROC)曲线分析DCE-MRI、DWI及二者联合对CGPCa的诊断价值。结果CGPCa组患者的容量转移常数(Ktrans)和速率常数(Kep)均明显大于BPH组患者(P<0.001),ADC值明显小于BPH组患者(P<0.001),两组患者的血管外细胞外空间容积分数(Ve)差异无统计学意义(P=0.391);CGPCa组患者中,低危组患者的Ktrans和Kep值均明显小于中高危组患者(P<0.001),ADC值明显大于中高危组患者(P<0.001),两组患者的Ve值比较差异无统计学意义(P=0.249);ROC曲线分析结果显示,Ktrans、Kep、ADC值及其联合诊断的曲线下面积(area under the curve,AUC)分别为0.732、0.813、0.862和0.901,对CGPCa的诊断均具有预测价值(P<0.001),且联合诊断的敏感度和特异度均高于单一指标(P<0.001)。结论DCE-MRI与DWI在CGPCa的鉴别诊断中均具有良好的应用价值,DCE-MRI的定量参数Ktrans、Kep值和ADC值可为临床CGPCa的鉴别诊断提供影像学参考,且联合诊断可进一步提高诊断效能。
Objective:To explore the application value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and diffusion-weighted imaging(DWI)in the diagnosis of central gland prostate cancer(CGPCa).Materials and Methods:The clinical data of 113 patients with prostate diseases confirmed by needle biopsy or surgical pathology in the hospital between January 2017 and January 2020 were retrospectively analyzed.According to the disease type,the patients were divided into CGPCa group(n=51)and benign prostatic hyperplasia group(BPH group,n=62).All patients were subjected to routine MR,DCE-MRI and DWI scanning.The MR images of the two groups were analyzed.The DCE-MRI quantitative parameters and apparent diffusion coefficient(ADC)values were compared between the two groups and between patients with different degrees of CGPCa.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of DCE-MRI,DWI and their combination in CGPCa.Results:The volume transfer(Ktrans)and rate constant(Kep)values of CGPCa group were significantly higher than those of BPH group(P<0.001),and the ADC value was significantly lower than that of BPH group(P<0.001),but there was no significant difference in the volume fraction(Ve)value between the two groups(P=0.391).In CGPCa group,the Ktrans and Kep values of the low-risk group were significantly lower than those of the middle and high-risk group(P<0.001),and the ADC value was significantly higher than that of the middle and high-risk group(P<0.001),but there was no significant difference in the Ve value between the two groups(P=0.249).ROC curve analysis results showed that the area under the curve(AUC)values of Ktrans,Kep,ADC value and their combined diagnosis were 0.732,0.813,0.862,and 0.901,respectively(P<0.001).The sensitivity and specificity of combined diagnosis were higher than those of each index(P<0.001).Conclusions:Both DCE-MRI and DWI can be used for differential diagnosis of CGPCa.The quantitative parameters Ktrans,Kep value and ADC value of DCE-MRI can provide imaging reference for clinical differential diagnosis of CGPCa,and the combined diagnosis can further improve the diagno stic efficiency.
作者
罗拥志
王习
LUO Yongzhi;WANG Xi(Department of Imaging,the Third Hospital of Changsha City,Hunan Province,Changsha 410003,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2021年第9期61-64,共4页
Chinese Journal of Magnetic Resonance Imaging
关键词
前列腺中央腺体癌
前列腺增生
动态对比增强磁共振成像
扩散加权成像
诊断
central gland prostate cancer
prostatic hyperplasia
dynamic contrast-enhanced magnetic resonance imaging
diffusion weighted imaging
diagnosis
