3.0T磁共振扩散加权成像在前列腺癌诊断与鉴别诊断中的应用
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摘要
目的探讨3.0T磁共振弥散加权成像(DWI)和表面弥散系数(ADC)在前列腺癌诊断及鉴别诊断中的应用价值。方法回顾性分析65例经穿刺活检病理证实的前列腺疾病患者,其中前列腺癌组21例,前列腺炎组19例,良性前列腺增生(BPH)组25例,测量病变区及前列腺增生外周带的ADC值,并在癌与非癌组之间进行受试者操作特征曲线(ROC)分析。结果前列腺癌组ADC值为(0.74±0.10)×10~(-3)mm~2/s,前列腺炎组为(0.98±0.07)×10~(-3)mm~2/s,BPH组中央带为(1.21±0.09)×10~(-3)mm~2/s,外周带为(1.38±0.14)×10~(-3)mm~2/s,组间ADC值两两比较,差异均有统计学意义(P<0.01)。根据ROC曲线,当ADC值为0.95×10~(-3)mm~2/s时,诊断的敏感性达92.8%,特异性达100%,ROC曲线下面积为0.995。结论磁共振DWI和ADC值可用于前列腺癌的诊断和鉴别诊断,具有很高的临床应用价值。
Objective To explore the applicability of diffusion-weighted imaging( DWI) and apparent diffusion coefficient( ADC) values in the diagnosis and differential diagnosis of prostatic cancer at 3. 0 T MR. Methods A total 65 patients who had been confirmed by pathological results were enrolled in this retrospective study,including 21 cases of prostatic cancer,19 cases of prostatitis and 25 cases of benign prostatic hyperplasia( BPH). The ADC values of each lesion and peripheral zone of BPH were measured and analyzed with one-way ANOVA and ROC analysis. Results The mean ADC values of the cancerous area,inflammatory area,prostatic central gland and peripheral zone of BPH were( 0. 74 ± 0. 10) × 10~(-3) mm~2/s,( 0. 98 ± 0. 07) × 10~(-3) mm~2/s,( 1. 21 ± 0. 09) × 10~(-3) mm~2/s and( 1. 38 ± 0. 14) × 10~(-3) mm~2/s,respectively. There was statistically significant difference in ADC values between the intergroups( P < 0. 01). With the ROC cut point set at 0. 95 × 10~(-3) mm~2/s,the diagnostic sensitivity and specificity for prostate cancer were 92. 8% and 100% respectively,while the area under the ROC curve( AUC) was 0. 995 ± 0. 005. Conclusions DWI and ADC values have good clinical applicability in the diagnosis and differential diagnosis of prostate cancer.
Objective To explore the applicability of diffusion-weighted imaging( DWI) and apparent diffusion coefficient( ADC) values in the diagnosis and differential diagnosis of prostatic cancer at 3. 0 T MR. Methods A total 65 patients who had been confirmed by pathological results were enrolled in this retrospective study,including 21 cases of prostatic cancer,19 cases of prostatitis and 25 cases of benign prostatic hyperplasia( BPH). The ADC values of each lesion and peripheral zone of BPH were measured and analyzed with one-way ANOVA and ROC analysis. Results The mean ADC values of the cancerous area,inflammatory area,prostatic central gland and peripheral zone of BPH were( 0. 74 ± 0. 10) × 10~(-3) mm~2/s,( 0. 98 ± 0. 07) × 10~(-3) mm~2/s,( 1. 21 ± 0. 09) × 10~(-3) mm~2/s and( 1. 38 ± 0. 14) × 10~(-3) mm~2/s,respectively. There was statistically significant difference in ADC values between the intergroups( P < 0. 01). With the ROC cut point set at 0. 95 × 10~(-3) mm~2/s,the diagnostic sensitivity and specificity for prostate cancer were 92. 8% and 100% respectively,while the area under the ROC curve( AUC) was 0. 995 ± 0. 005. Conclusions DWI and ADC values have good clinical applicability in the diagnosis and differential diagnosis of prostate cancer.
引文
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[12]Liu X H,Zhou B N,Zhou LP,et al.Differentiation of prostate cancer and stromal hyperplasia in the transition zone with histogram analysis of the apparent diffusion coefficient[J].Acta Radiologica,2017,58(12):1528-1534.
[13]刘晓东,唐桑,周美红,等.1.5T MR超高b值DWI对前列腺癌的诊断价值[J].实用放射学杂志,2017,33(8):1290-1293.
[2]Ferlay J,Soerjomataram I,Dikshit R,et al.Cancer incidence and mortality worldwide:sources,methods and major patterns in GLOBOCAN 2012[J].Int J Cancer2015,136(5):359-386.
[3]Hricak H,Choyke PL,Eberhardt SC,et al.Imaging prostate cancer:a multidisciplinary perspective[J].Radiology,2007,243(1):28-53.
[4]Turkbey B,Albert P S,Kurdziel K,et al.Imaging localized prostate cancer:current approaches and new developments[J].AJR,2009,192(6):1471-1480.
[5]杨光华,病理学[M].5版.北京:人民卫生出版社,2003,80-121.
[6]冯光耀.磁共振扩散加权成像在诊断与鉴别诊断早期前列腺癌临床分析[J].临床医学,2016,36(5):92-94.
[7]王化敏,夏黎明,金红花,等.磁共振DWI结合T2WI在前列腺疾病诊断中的价值[J].放射学实践,2010,25(12):1384-1387.
[8]闫晨宇,程敬亮,高雪梅,等.3.0T磁共振平扫和DWI在前列腺癌诊断中的应用[J].实用放射学杂志,2013,29(1):72-76.
[9]张莹,苗华栋,陈丽娟,等.3.0T MR扩散加权成像与表观扩散系数诊断前列腺癌的比较[J].中国医学影像学射学杂志,2013,21(8):602-605.
[10]张琨,张晓晶,钟燕,等.超高b值扩散加权成像对前列腺中央腺体癌的诊断价值[J].中华放射学杂志,2016,50(5):357-361.
[11]陈志强,杨文君,郭玉林,等.磁共振扩散加权成像在前列腺癌诊断和鉴别诊断中的价值[J].中华老年医学杂志,2011,30(3):216-219.
[12]Liu X H,Zhou B N,Zhou LP,et al.Differentiation of prostate cancer and stromal hyperplasia in the transition zone with histogram analysis of the apparent diffusion coefficient[J].Acta Radiologica,2017,58(12):1528-1534.
[13]刘晓东,唐桑,周美红,等.1.5T MR超高b值DWI对前列腺癌的诊断价值[J].实用放射学杂志,2017,33(8):1290-1293.