DWI对前列腺癌诊断与Gleason评分的相关性分析
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摘要
目的探讨磁共振扩散加权成像(DWI)对前列腺癌检出率与Gleason评分的相关性。方法收集91例有完整病理资料且临床怀疑前列腺癌的患者,行常规序列(T1WI/T2WI)与DWI(b值为600s/mm~2)检查。对病理诊断为前列腺癌的病例行Gleason评分。结果 91例中,前列腺增生44例(以下称前列腺增生组)、前列腺癌47例(以下称前列腺癌组)。前列腺增生组与前列腺癌组的表观扩散系数(ADC)值分别为(1.250±0.263)×10~(-3) mm~2/s和(0.955±0.191)×10~(-3) mm~2/s。前列腺癌组根据Gleason评分分为高分化、中分化和低分化3个组,其ADC值分别为(1.158±0.173)×10~(-3) mm~2/s、(1.050±0.192)×10~(-3) mm~2/s和(0.891±0.241)×10~(-3) mm~2/s。ADC值对前列腺癌高分化组、中分化组和低分化组的诊断准确率分别为63.6%、78.3%、84.6%。前列腺癌不同病理分组的ADC值与Gleason评分呈负相关;DWI诊断前列腺癌的准确率与Gleason评分呈正相关。结论前列腺癌分化程度越低,Gleason评分分值越高,DWI诊断的准确性也越高。
Objective To explore the correlation between the detection rate of diffusion weighted imaging(DWI)in diagnosis prostate cancer and the Gleason score.Methods Ninety-one cases of intact pathological data and clinically suspected prostate cancer were collected.All cases were undertaken the routine sequence(T1 WI/T2 WI)and DWI(value b=600 s/mm~2)examination.The cases of pathologically diagnosed prostate cancer were performed the Gleason score.Results Among 91 cases,44 cases were benign prostatic hyperplasia(BPH)and 47 cases were prostate carcinoma(PCa).The ADC values in the BPH group and PCa group were(1.250±0.263)×10~(-3) mm~2/s and(0.955±0.191)×10~(-3) mm~2/s.According to Gleason score,the PCa group was re-divided into three sub-groups:high differentiation,middle differentiation and low differentiation,the apparent diffusion coefficient(ADC)values were(1.158±0.173)×10~(-3) mm~2/s,(1.050±0.192)×10~(-3) mm~2/s and(0.891±0.241)×10~(-3) mm~2/s respectively.Their diagnostic accuracy rates for diagnosing PCa were 63.6% ,78.3% and 84.6% respectively.The ADC value of different pathological groups in PCa with Gleason score is negatively correlated with the Gleason score.The accuracy rate of DWI in diagnosis of PCa is positively correlated with the Gleason score.Conclusion The lower prostate cancer differentiation,the higher Gleason score and the higher accuracy of DWI in diagnosing PCa.
Objective To explore the correlation between the detection rate of diffusion weighted imaging(DWI)in diagnosis prostate cancer and the Gleason score.Methods Ninety-one cases of intact pathological data and clinically suspected prostate cancer were collected.All cases were undertaken the routine sequence(T1 WI/T2 WI)and DWI(value b=600 s/mm~2)examination.The cases of pathologically diagnosed prostate cancer were performed the Gleason score.Results Among 91 cases,44 cases were benign prostatic hyperplasia(BPH)and 47 cases were prostate carcinoma(PCa).The ADC values in the BPH group and PCa group were(1.250±0.263)×10~(-3) mm~2/s and(0.955±0.191)×10~(-3) mm~2/s.According to Gleason score,the PCa group was re-divided into three sub-groups:high differentiation,middle differentiation and low differentiation,the apparent diffusion coefficient(ADC)values were(1.158±0.173)×10~(-3) mm~2/s,(1.050±0.192)×10~(-3) mm~2/s and(0.891±0.241)×10~(-3) mm~2/s respectively.Their diagnostic accuracy rates for diagnosing PCa were 63.6% ,78.3% and 84.6% respectively.The ADC value of different pathological groups in PCa with Gleason score is negatively correlated with the Gleason score.The accuracy rate of DWI in diagnosis of PCa is positively correlated with the Gleason score.Conclusion The lower prostate cancer differentiation,the higher Gleason score and the higher accuracy of DWI in diagnosing PCa.
引文
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[6]马艺宁,杨华.前列腺癌预后因素的探讨[J].病理学杂志,2007,14(5):387-389.
[7]利华,郑晓林,高云,等.MR扩散加权成像评价前列腺癌生物学特性的研究[J].临床放射学杂志,2011,30(5):678-680.
[8]VERMA S,RAJESH A,MORALES H,et al.Assessment of aggressiveness of prostate cancer:correlation of apparent diffusion coefficient with histologic grade after radical prostatectomy[J].AJR Am J Roentgenol,2011,196(2):374-381.
[9]RSENKTRATZ A B,HINDMAN N,LIM R P,et al.Diffusion-Weighted Imaging of The Prostate:Comparison of b1000and b2000Image Sets for Index Lesion Detection[J].J Magn Reson Imaging,2013,38(3):694-700.
[2]任静,宦恰,常英娟,等.DWI在正常前列腺及前列腺疾病的初步应用[J].中国医学影像技术,2007,23(5):748-750.
[3]吴道清,陈自谦.DCE-MRI与DWI对良恶性前列腺疾病诊断的价值[J].临床放射学杂志,2010,29(2):211-215.
[4]沈新平,叶炯贤,张娜,等.扩散加权成像对诊断前列腺癌的初步研究[J].中国医学影像学杂志,2012,20(7):485-488.
[5]王功伟,沈丹华.国际泌尿病理协会前列腺癌Gleason分级系统基本特征初步分析[J].中华男科学杂志,2014,22(6):514-517.
[6]马艺宁,杨华.前列腺癌预后因素的探讨[J].病理学杂志,2007,14(5):387-389.
[7]利华,郑晓林,高云,等.MR扩散加权成像评价前列腺癌生物学特性的研究[J].临床放射学杂志,2011,30(5):678-680.
[8]VERMA S,RAJESH A,MORALES H,et al.Assessment of aggressiveness of prostate cancer:correlation of apparent diffusion coefficient with histologic grade after radical prostatectomy[J].AJR Am J Roentgenol,2011,196(2):374-381.
[9]RSENKTRATZ A B,HINDMAN N,LIM R P,et al.Diffusion-Weighted Imaging of The Prostate:Comparison of b1000and b2000Image Sets for Index Lesion Detection[J].J Magn Reson Imaging,2013,38(3):694-700.