MRI多参数成像联合血清PSA对前列腺癌的诊断价值
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摘要
目的探讨MRI多参数成像联合血清PSA对前列腺癌(PCa)的诊断价值。方法选取我院2015年1月至2018年5月收治的疑似PCa患者69例,所有患者均进行血清PSA、 3.0T MRI常规、 DWI及DCE-MRI检查,以术后病理结果作为诊断标准,分析PCa及前列腺增生(BPH)的DCE-MRI信号变化,时间-信号强度曲线(TIC)特征。采用以下三种技术方案:方案1:T1WI、 T2WI+DWI;方案2:T1WI、 T2WI+DCE-MRI;方案3:T1WI、 T2WI+DWI+DCE-MRI。以上三种方案均联合血清PSA,计算各方案的敏感度、特异度及准确度。结果 BPH与PCa的平均达峰时间(Tmax)、最大增强斜率(MSI)及信号增强率(SER)比较,差异有统计学意义(P <0.05)。BPH的TIC多表现为Ⅰ或Ⅱ型, PCa的TIC多表现为Ⅲ型,两者比较差异有统计学意义(P <0.05)。T1WI、 T2WI+DWI+DCE-MRI联合血清PSA诊断前列腺癌的敏感度、特异度、准确度最高,分别为93.7%、 90.5%、 91.3%。结论 T1WI、 T2WI+DWI+DCE-MRI检查联合血清PSA可提高前列腺癌的术前诊断率。
Objective To evaluate the diagnostic value of MRI multi-parameter imaging combined with serum PSA in prostate cancer(PCa). Methods 69 patients with suspected PCa treated in our hospital from January 2015 to May 2018 were selected. All patients were examined by serum PSA, 3.0 T MRI routine, DWI and DCE-MRI. The postoperative pathological results were used as the standard diagnosis.The changes of DCE-MRI signal and time of intensity curve(TIC) characteristics of PCa and benign prostatic hyperplasia(BPH) were analyzed. The following three technical schemes were used: scheme 1: T1 WI, T2 WI + DWI; Scheme 2: T1 WI, T2 WI + DCE-MRI; Scheme 3:T1 WI, T2 WI + DWI + DCE-MRI. All the three schemes were combined with serum PSA, and the sensitivity, specificity and accuracy of each scheme were calculated. Results The average time to peak(Tmax), maximum slop of increase(MSI) and signal enhancement rate(SER) of BPH and PCa were significantly different(P <0.05). The TIC of most BPH showed type Ⅰ or type Ⅱ, ant the TIC of most PCa showed typeⅢ, with significant difference between BPH and PCa(P <0.05). The sensitivity, specificity and accuracy of T1 WI, T2 WI + DWI + DCE-MRI combined with serum PSA in the diagnosis of prostate cancer were the highest(93.7%, 90.5% and 91.3%). Conclusions T1 WI, T2 WI + DWI+ DCE-MRI combined with serum PSA can improve the preoperative diagnosis rate of prostate cancer.
Objective To evaluate the diagnostic value of MRI multi-parameter imaging combined with serum PSA in prostate cancer(PCa). Methods 69 patients with suspected PCa treated in our hospital from January 2015 to May 2018 were selected. All patients were examined by serum PSA, 3.0 T MRI routine, DWI and DCE-MRI. The postoperative pathological results were used as the standard diagnosis.The changes of DCE-MRI signal and time of intensity curve(TIC) characteristics of PCa and benign prostatic hyperplasia(BPH) were analyzed. The following three technical schemes were used: scheme 1: T1 WI, T2 WI + DWI; Scheme 2: T1 WI, T2 WI + DCE-MRI; Scheme 3:T1 WI, T2 WI + DWI + DCE-MRI. All the three schemes were combined with serum PSA, and the sensitivity, specificity and accuracy of each scheme were calculated. Results The average time to peak(Tmax), maximum slop of increase(MSI) and signal enhancement rate(SER) of BPH and PCa were significantly different(P <0.05). The TIC of most BPH showed type Ⅰ or type Ⅱ, ant the TIC of most PCa showed typeⅢ, with significant difference between BPH and PCa(P <0.05). The sensitivity, specificity and accuracy of T1 WI, T2 WI + DWI + DCE-MRI combined with serum PSA in the diagnosis of prostate cancer were the highest(93.7%, 90.5% and 91.3%). Conclusions T1 WI, T2 WI + DWI+ DCE-MRI combined with serum PSA can improve the preoperative diagnosis rate of prostate cancer.
引文
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[2]冷晓明,韩晓蕊,徐嬿,等. IVIM-DWI和定量DCE-MRI鉴别前列腺癌和前列腺增生--灌注系数的相关性研究[J].影像诊断与介入放射学, 2016, 25(5):390-395.
[3]黄云海,郭永梅,徐宏刚,等. DCE-MRI半定量参数及定量参数在前列腺癌诊断的综合应用研究[J].中国CT和MRI杂志, 2016,14(3):75-77.
[4]钟华,郭燕丽,张丰,等.经直肠超声引导下前列腺穿刺活检结合血清PSA在诊断前列腺癌中的价值[J].第三军医大学学报, 2016,38(6):638-641.