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目的运用3.0 T MR多b值DWI探讨b值选择对前列腺中央腺体癌(CGPCa)及良性前列腺增生(BPH)鉴别效能的影响。方法经病理证实的28例CGPCa及23例BPH患者行常规序列及DWI序列扫描,DWI设定4个b值(0、500、1000、1500 s/mm~2),分别选取b=0、1000 s/mm~2,b=0、500、1000 s/mm~2,b=0、1500 s/mm~2,b=0、500、1500 s/mm~2,b=0、1000、1500 s/mm~2,b=0、500、1000、1500 s/mm~2拟合得到ADC图,测量感兴趣区域(ROI)的ADC值。采用两独立样本t检验比较CGPCa组与BPH组ADC值的差异,应用受试者工作特征(ROC)曲线评价不同b值组合的诊断效能。结果 b=0、1000 s/mm~2和b=0、500、1000 s/mm~2两组在CGPCa及BPH组各ROI的ADC值均相等。CGPCa及BPH组在不同b值组合下ADC值差异均有显著统计学意义(P<0.001)。b=0、1000 s/mm~2,b=0、500、1000 s/mm~2,b=0、1500 s/mm~2,b=0、500、1500 s/mm~2,b=0、1000、1500 s/mm~2,b=0、500、1000、1500 s/mm~2的曲线下面积(AUC)分别为0.912、0.912、0.952、0.950、0.952、0.950;两两比较显示b=0、1500s/mm~2,b=0、1000、1500 s/mm~2,b=0、500、1000、1500 s/mm~2三组分别与b=0、1000 s/mm~2和b=0、500、1000 s/mm~2组的AUC比较差异有统计学意义,P值分别为0.015、0.009、0.015。在b=0、1500 s/mm~2组,当ADC值阈值为0.901×10~(-3)mm~2/s时,诊断CGPCa的敏感性为92.86%,特异性为100%,阳性预测值为100%,阴性预测值为85.2%。结论 b=1500 s/mm~2的高b值DWI对于鉴别CGPCa与BPH具有显著意义,诊断效能优于b=1000 s/mm~2的常规DWI。
Objective To investigate the effect of b-value selection on the differential diagnosis of benign prostatic hyperplasia (BPH) and benign prostatic hyperplasia (BPH) using 3.0 T MR multi-b DWI. Methods Totally 28 cases of CGPCa and 23 cases of BPH confirmed by pathology were scanned by conventional sequence and DWI. Four b values (0, 500, 1000 and 1500 s / mm ~ 2) were set by DWI, and b = 0,1000 b = 0, 1500 s / mm ~ 2, b = 0, 1500 s / mm ~ 2, b = s / mm ~ 2, b = 0, 500, 1000, 1500 s / mm ~ 2 were fitted to obtain the ADC map and measure the ADC value of the region of interest (ROI). The differences of ADC values between CGPCa group and BPH group were compared by two independent samples t-test. The diagnostic performance of different b value combinations was evaluated by receiver operating characteristic (ROC) curves. Results The ADC values of ROI in CGPCa and BPH groups were the same for both b = 0,1000 s / mm ~ 2 and b = 0,500,1000 s / mm ~ 2. There was significant difference in ADC value between CGPCa and BPH group under different b values (P <0.001). b = 0,1000 s / mm ~ 2, b = 0,500,1000 s / mm ~ 2, b = 0,1500 s / mm ~ 2, b = 0,500,1500 s / mm ~ 2, b = The area under the curve (AUC) of 0,1000,1500 s / mm ~ 2 and b = 0,500,1000,1500 s / mm ~ 2 were 0.912,0.912,0.952,0.950,0.952,0.950, respectively; b = 0,1500s / mm ~ 2, b = 0,1000,1500 s / mm ~ 2 and b = 0,500,1000,1500 s / mm ~ 2 and b = 0,500,1000 s / mm ~ 2 group AUC difference was statistically significant, P values were 0.015,0.009,0.015. In the b = 0,1500 s / mm ~ 2 group, the sensitivity of CGPCa was 92.86% and the specificity was 100% when the ADC value was 0.901 × 10 -3 mm 2 / s. The positive predictive value The value was 100% and the negative predictive value was 85.2%. Conclusion High b value DWI with b = 1500 s / mm ~ 2 is significant for distinguishing CGPCa from BPH, and its diagnostic efficiency is superior to conventional DWI with b = 1000 s / mm ~ 2.