磁共振成像表观扩散系数对前列腺癌分级诊断的价值

来源 :中国临床医学 | 被引量 : 0次 | 上传用户:lwh849453
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目的:回顾分析前列腺癌、前列腺增生及正常前列腺的磁共振成像(magnetic resonance imaging,MRI)信号差异,探讨表观扩散系数(apparent diffusion coefficient,ADC)在前列腺癌分级中的价值。方法:收集复旦大学附属中山医院2013年1月至2014年3月收治的前列腺癌患者40例(包括高危组和低中危组)和前列腺增生患者11例,均经手术或穿刺病理诊断证实;同时,入组正常对照组20例,均为健康志愿者。对3组患者及志愿者进行常规MRI检查及弥散加权成像(magnetic resonance diffusion weighted imaging,DWI)检查,比较各组的T_2WI信号强度、T_1WI平扫动静脉期的信号强度和ADC值,并将前列腺癌的ADC值与Gleason评分进行相关分析,确定利用ADC值鉴别高危与低中危前列腺癌的临界值。结果:在T_2WI信号强度和ADC值方面,前列腺癌组、前列腺增生组和正常对照组依次递增,3组间差异均有统计学意义(P<0.05);在T_1WI信号强度方面,只有正常前列腺中央带的动静脉期信号强度差值显著高于前列腺癌组和前列腺增生组,差异有统计学意义(P<0.05)。前列腺癌的ADC值与Gleason评分负相关(r=-0.401,P=0.010),即Gleason评分越高,ADC值越小。以ADC值0.70×10~(-3) mm~2/s为临界值,鉴别诊断低中危组和高危组前列腺癌的敏感度为96.4%,特异度为58.3%。结论:T_2WI信号强度和ADC值可用于鉴别前列腺癌、前列腺增生及正常前列腺,T_1WI动静脉期信号差值也有一定的参考价值;前列腺癌ADC值与Gleason评分有一定的相关性,提示ADC值可用于前列腺癌临床危险度的分级诊断。 OBJECTIVE: To investigate the difference of magnetic resonance imaging (MRI) signal in prostate cancer, benign prostatic hyperplasia and normal prostate to investigate the value of apparent diffusion coefficient (ADC) in the classification of prostate cancer. Methods: Forty patients (including high risk group and low risk group) with benign prostatic hyperplasia (BPH) and benign prostatic hyperplasia (BPH) were enrolled in Zhongshan Hospital affiliated to Fudan University from January 2013 to March 2014, and 11 patients with benign prostatic hyperplasia were confirmed by pathological diagnosis. At the same time, 20 normal subjects were recruited as healthy volunteers. The routine MRI examination and DWI were performed on 3 groups of patients and volunteers to compare the signal intensity of T 2 WI and the signal intensity and ADC of T 1 WI in the venous phase. Correlation analysis of ADC value and Gleason score of cancer, to determine the use of ADC value to identify high-risk and low-risk prostate cancer threshold. Results: There were significant differences in T 2 WI signal intensity and ADC value between prostate cancer group, benign prostatic hyperplasia group and normal control group (P <0.05). In the aspect of signal intensity of T 1 WI, only the center of normal prostate The difference of signal intensity between the arteriovenous phase and the BPH group was significantly higher than that of the prostate cancer group and benign prostatic hyperplasia group (P <0.05). The ADC value of prostate cancer was negatively correlated with the Gleason score (r = -0.401, P = 0.010). The higher the Gleason score, the lower the ADC value. With ADC value of 0.70 × 10 ~ (-3) mm ~ 2 / s as the critical value, the sensitivity and specificity of differential diagnosis of prostate cancer in low-risk group and high-risk group were 96.4% and 58.3% respectively. Conclusion: The signal intensity of T2WI and ADC value can be used to identify the difference of signal between arterial and venous phase in prostate cancer, benign prostatic hyperplasia and normal prostate. There is a certain correlation between ADC value and Gleason score in prostate cancer, suggesting that ADC value is available Hierarchical diagnosis of clinical risk of prostate cancer.
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