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目的通过分析前列腺癌动态增强MRI(DCE-MRI)的相关参数与病理Gleason评分的关系,探讨DCE-MRI评价前列腺癌生物学特性的应用价值。方法使用3.0 T MR扫描仪对经组织病理学证实的53例前列腺癌患者行肝脏快速容积采集序列(LAVA)多期动态增强扫描,通过GE 4.3工作站进行数据处理获得双侧外周带癌区与非癌区信号强度-时间(SI-T)曲线,计算出达峰时间(Tmax)、最大强化程度(SImax%)和最快强化率(Rmax),并分别分析与Gleason评分之间是否存在相关性。结果前列腺癌患者癌区Tmax、SImax%、Rmax的平均值分别为(17.13±3.33)s、(1.60±0.26)%、(9.31±2.43)%,癌区动态增强参数与非癌区具有显著差异(P<0.01)。前列腺癌Glea-son评分2～6分、7分、8～10分的Tmax、SImax%、Rmax的平均值经方差分析均有统计学意义(P<0.05)。前列腺癌Tmax与Gleason评分呈负相关(r=-0.52,P<0.05),SImax%、Rmax与Gleason评分存在正相关关系(r=0.43、0.52,P<0.05)。结论前列腺癌动态增强相关参数与Gleason评分具有相关性,可以对前列腺癌的生物学特性进行初步评估。
Objective To investigate the value of DCE-MRI in evaluating the biological characteristics of prostate cancer by analyzing the relationship between the parameters of dynamic contrast-enhanced prostate cancer (DCE-MRI) and pathological Gleason score. Methods A multistage dynamic contrast-enhanced laser scanning (LAVA) scan of 53 cases of prostate cancer confirmed by histopathology was performed with a 3.0 T MR scanner. Data were processed by GE 4.3 workstation to obtain bilateral peripheral zone cancerous regions (Tmax), maximum intensity (SImax%) and maximum enhancement rate (Rmax) were calculated and compared with Gleason score . Results The average values of Tmax, SImax% and Rmax in cancer patients were (17.13 ± 3.33) s and (1.60 ± 0.26)%, (9.31 ± 2.43)%, respectively. The dynamic enhancement parameters of cancer patients were significantly different from those of non-cancer patients (P <0.01). The mean values of Tmax, SImax% and Rmax of patients with prostate cancer with Glea-son score of 2 to 6, 7 and 8 to 10 were all statistically significant by ANOVA (P <0.05). There was a positive correlation between Tmax and Gleason score (r = -0.52, P <0.05), SImax%, Rmax and Gleason score (r = 0.43,0.52, P <0.05) in prostate cancer. Conclusion The correlation between dynamic enhancement of prostate cancer and Gleason score may be related to the preliminary evaluation of the biological characteristics of prostate cancer.