动态增强MRI结合DWI对前列腺癌的诊断价值分析
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摘要
目的研究动态增强MRI结合DWI对前列腺癌的诊断价值。方法选取2016年1月—2017年12月在该院就诊怀疑前列腺癌的患者50例,经病理确诊前列腺癌患者32例为观察组,良性前列腺增生18例为对照组,对比两组患者在常规MR、DWI、 DCE-MR扫描下的参数。结果观察组的患者ADC值(0.79±0.28)10~(-3) mm~2/s低于对照组(1.03±0.22)10~(-3)mm~2/s的患者。DWI信号强度在50 s/mm~2观察组为(90.42±10.15),在800 s/mm~2观察组为(104.66±60.05)均低于对照组。DCE-MRI的三个参数Ktrans、Vc、Kep观察组分别为:(0.34±0.04)min~(-1)、(0.29±0.09)%、(0.79±0.08)min~(-1)均高于对照组。通过回归分析发现:Ktrans与Gleason评分成正相关(P=0.000)。结论动态增强MRI结合DWI利于前列腺癌的诊断,对判断前列腺癌的分化程度及预后有一定价值,但是各种指标的相关性还需进一步研究。
Objective To study the value of dynamic enhanced MRI combined with DWI in the diagnosis of prostate cancer. Methods A total of 50 patients with suspected prostate cancer were enrolled in our hospital from January 2016 to December 2017. 32 patients with pathologically diagnosed prostate cancer were included in the observation group,and 18 patients with benign prostatic hyperplasia were included in the control group. Parameters under MR, DWI,DCE-MR scanning were observed. Results obseruation group ADC value of(0.79±0.28)10~(-3) mm~2/s lower than control(1.03 ± 0.22) 10~(-3) mm~2/s. The DWI signal intensity was(90.42 ±10.15) in the observation group at 50 s/mm~2 and(104.66±60.05) in the observation group at 800 s/mm~2. The three parameters of DCE-MRI were Ktrans, Vc, and Kep observation group:(0.34±0.04) min~(-1)(0.29±0.09)%, and(0.79±0.08) min~(-1) were higher than the control group. Through regression analysis, it was found that Ktrans was positively correlated with Gleason score(P=0.000). Conclusion Dynamic enhanced MRI combined with DWI is beneficial to the diagnosis of prostate cancer. It has certain value in judging the differentiation degree and prognosis of prostate cancer, but the correlation of various indicators needs further study.
Objective To study the value of dynamic enhanced MRI combined with DWI in the diagnosis of prostate cancer. Methods A total of 50 patients with suspected prostate cancer were enrolled in our hospital from January 2016 to December 2017. 32 patients with pathologically diagnosed prostate cancer were included in the observation group,and 18 patients with benign prostatic hyperplasia were included in the control group. Parameters under MR, DWI,DCE-MR scanning were observed. Results obseruation group ADC value of(0.79±0.28)10~(-3) mm~2/s lower than control(1.03 ± 0.22) 10~(-3) mm~2/s. The DWI signal intensity was(90.42 ±10.15) in the observation group at 50 s/mm~2 and(104.66±60.05) in the observation group at 800 s/mm~2. The three parameters of DCE-MRI were Ktrans, Vc, and Kep observation group:(0.34±0.04) min~(-1)(0.29±0.09)%, and(0.79±0.08) min~(-1) were higher than the control group. Through regression analysis, it was found that Ktrans was positively correlated with Gleason score(P=0.000). Conclusion Dynamic enhanced MRI combined with DWI is beneficial to the diagnosis of prostate cancer. It has certain value in judging the differentiation degree and prognosis of prostate cancer, but the correlation of various indicators needs further study.
引文
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[10]Wang L,Mazaheri Y,Zhang J,et al.Assessment of biologic aggressiveness of prostate cancer:correlation of MR signal intensity with Gleason grade after radical prostatectomy.Radiology,2008,246(1):168-176.
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[2]S Woo,SY Kim,J Lee,et al.关于第二版PI-RADS对经活检证实Gleason评分7分(3+4)前列腺癌病人进行根治性切除术后病灶病理降级情况预测能力的初步研究[J].国际医学放射学杂志,2016,39(6):710.
[3]刘书林,方向军,刘芬.前列腺癌多参数MRI应用现状及进展[J].磁共振成像,2017,8(5):394-400.
[4]司慧勇,胡娟,王霄英,等.磁共振扩散加权成像表观扩散系数值在前列腺癌诊断中的应用价值[J].中国药物与临床,2017,17(2):204-205.
[5]方孙福,周晓燕,罗朝军,等.动态增强MRI结合DWI对前列腺癌的诊断价值分析[J].医学影像学杂志,2017,27(1):186-188.
[6]李鹏,黄英,李艳,等.多参数磁共振成像诊断和鉴别诊断外周带早期前列腺癌和前列腺炎[J].中华医学杂志,2016,96(37):2973-2977.
[7]王君鑫.动态增强MRI定量研究中感兴趣区设置方法和定量参数直方图分析在前列腺癌诊断中的初步评价[D].苏州:苏州大学,2016.
[8]余永强,李小虎.动态增强磁共振成像在肿瘤中的研究进展[J].临床放射学杂志,2016,35(4):642-644.
[9]何永胜,戚轩,张敏,等.ADC值及Ktrans值与前列腺癌Gleason评分的相关性研究[J].中国CT和MRI杂志,2017,15(2):66-69.
[10]Wang L,Mazaheri Y,Zhang J,et al.Assessment of biologic aggressiveness of prostate cancer:correlation of MR signal intensity with Gleason grade after radical prostatectomy.Radiology,2008,246(1):168-176.
[11]高鹏,赵莲萍,史长征,等.前列腺癌Ktrans值与肿瘤Gleason评分的相关性:Meta分析[J].中国医学影像学杂志,2016,24(9):696-700.