摘要
目的基于PI-RADS v2探讨3.0T扩散加权成像(DWI)及动态增强扫描(DCE-MRI)在前列腺癌诊断中的价值。方法 (1)回顾性分析经3.0T MRI扫描、由病理证实的149例前列腺疾病患者临床资料,其中前列腺癌63例,前列腺增生86例,后处理测量外周带、中央带病灶的ADC值、绘制TIC曲线,统计学方法分析ADC值及TIC曲线类型在前列腺良恶性病变中的诊断效能。(2)综合T2WI、DWI、DCE-MRI得出PI-RADS v2评分,统计学方法分析PI-RADS v2在前列腺病变中的诊断效能。结果 (1)利用ROC曲线得出外周带病灶ADC值诊断前列腺癌的界值为0.995×10-3mm2/s,敏感度90.2%、特异度89.8%、准确度90.1%,约登指数0.800;中央带病灶ADC值诊断前列腺癌的界值为1.023×10-3mm2/s,敏感度81.4%、特异度84.2%、准确度82.3%,约登指数0.656;外周带、中央带ADC值诊断前列腺癌具有高度一致性。(2) TIC曲线类型Ⅰ、Ⅱ型诊断为良性,Ⅲ型诊断为恶性,敏感度、特异度及准确度分别为61.7%、70.8%、67.1%,TIC曲线类型诊断前列腺癌的一致性一般。(3) PI-RADS v2评分本研究取1、2、3分诊断为良性,4、5分诊断为恶性,对应的敏感度、特异度及准确度分别为84.6%、90.5%及87.9%,两组间差异具有统计学意义;PI-RADS v2诊断前列腺癌具有高度一致性。结论 (1) DWI和DCE-MRI在前列腺癌的诊断中具有重要的价值。(2) ADC值在诊断外周带癌及中央带癌方面均具有较高的诊断效能。(3) TIC曲线类型在前列腺癌中的诊断价值一般。(4) PI-RADS v2在前列腺癌诊断中具有较高的诊断价值。
Objective To investigate the value of PI-RADS v2 based 3.0 T diffusion weighted imaging(DWI)and dynamic contrast-enhanced MRI(DCE-MRI)in the diagnosis of prostate cancer.Methods Retrospectively analyzed 149 cases of prostatic diseases proved by3.0 T MRI examination and pathology,of which63 cases of prostate cancer,86 cases of benign prostatic hyperplasia.The ADC values of focus of peripheral and central bands of the prostate gland were detected and drew a TIC curve.The statistical analysis methods were used to analyze the diagnostic efficacy of ADC values and TIC curve types in diagnosis of benign and malignant lesions of prostate.The score of PI-RADS v2 was obtained from the synthesis of T2 WI,DWI and DCE-MRI,and the diagnostic efficacy of PI-RADS v2 in prostatic lesions was analyzed statistically.Results The cut off value of ADC value of peripheral band was 0.995*10-3 mm2/s according the ROC curve,the sensitivity was 90.2%,the specificity was 89.8%and the accuracy was 90.1%,the Youden index was 0.800;The cutoff value of ADC value of central zone was 1.023*10-3 mm2/s,the sensitivity was 81.4%,the specificity was 84.2%and the accuracy was 82.3%,the Youden index was 0.656.ADC values of both peripheral zone and central zone have high degree of consistency on diagnosis of prostate cancer.When the TIC curve was Type I and II,the disease was diagnosed as BPH;when the curve was type III the disease was diagnosed as PCa.The sensitivity,specificity and accuracy were 61.7%,70.8%and 67.1%.TIC curve types have a genera degree of consistency on diagnosis of prostate cancer.In this study,when the PI-RADS v2 scores were1,2,and 3,the disease was diagnosed as BPH,and when the scores were 4 and 5 the disease was diagnosed as PCa.The sensitivity,specificity and accuracy were 84.6%,90.5%and 87.9%.PI-RADS v2 presented a high degree of consistency in the diagnosis of prostate cancer.Conclusions DWI and DCE-MRI have important value in the diagnosis of prostate cancer.ADC value has a high diagnostic efficiency in the diagnosis of peripheral and central prostate cancer.TIC curve type had no significant value in the diagnosis of prostate cancer.PI-RADS v2 has high diagnostic efficacy in the diagnosis of prostate cancer.
作者
于娟
马宜传
YU Juan(Radiological department,the first affiliated hospital of Bengbu Medical College,Bengbu,Anhui,233030,China.)
出处
《齐齐哈尔医学院学报》
2019年第16期2001-2006,共6页
Journal of Qiqihar Medical University
