摘要
目的探讨磁共振扩散加权成像对前列腺癌的诊断价值并寻找诊断前列腺癌的适宜阈值。方法 74例前列腺癌疑诊患者行3.0 T MR常规平扫及DWI成像。测量ADC map图中每侧外周带的ADC低值。外周带穿刺发现腺癌为阳性组,无肿瘤证据为阴性组。比较阴性组与阳性组,分化较好腺癌组(Gleason评分2～6分)与分化较差腺癌组(Gleason评分7～10分)的ADC低值差异。以ADC低值预测外周带穿刺阳性率,绘制ROC曲线。结果74例患者中146个前列腺侧叶(阴性组50,阳性组96)获得组织学证实,其中分化较好腺癌(Gleason评分2～6分)17个,分化较差腺癌(Gleason评分7～10分)79个。阳性组与阴性组间ADC低值差异有统计学意义(0.92×10-3±0.22×10-3 mm2/s vs 1.48×10-3±0.28×10-3 mm2/s,t=12.27,P=0.00)。分化较好腺癌组与分化较差腺癌组差异有统计学意义(1.04×10-3±0.20×10-3 mm2/s vs 0.89×10-3±0.21×10-3 mm2/s,t=2.60,P=0.01)。分化较好腺癌组与阴性组ADC低值差异亦有统计学意义(t=5.91,P=0.00)。以ADC低值预测外周带穿刺阳性率,ROC曲线下面积为0.95(P=0.00),最佳临界值为1.15×10-3mm2/s,此时判断穿刺阳性的敏感度为85.4%,特异度为92.0%。结论 MR DWI出现对于前列腺癌的诊断具有较高价值,ADC低值小于1.15×10-3mm2/s可能是较适宜的诊断界值。
Purpose To evaluate the diagnostic value of diffusion weighted MR imaging （DWI） in prostate cancer using 3.0T MR. Methods Seventy-four patients with suspected prostate cancer underwent DWI （ b = 0, 800） using 3.0 T MR. The apparent diffusion coefficient （ADC） values of all patients were measured by a radiologist unaware of the pathological results. The mean values of the low-value region in ADC map in bilateral peripheral zones （PZs） were measured respectively and recorded as the low-ADC values. The PZs were divided into positive group and negative group according to the pathological results of transrectal ultrasound （TRUS） guided biopsy. The low-ADCs were compared between the positive group and the negative group, as well as between the well-differentiated cancer （Gleason Score 2-6） and the poor-differentiated cancer （Gleason Score 7-10） using t test （SPSS 13.0）. A P value of less than 0.05 wasconsidered to indicate a statistically significant difference. Kesults In the /4 patients, 146PZs were pathologically examined, 50 PZs were classified into negative group, and 96 PZs were classified into positive group （ 17 with well-differen- tiated cancer, 79 with poor differentiated cancer）. The low-ADC was 0.92 × 10^-3±0. 22× 10^-3 mm^2/s for the positive group and 1.48×10^-3±0. 28× 10^-3 mm^2/s for the negative group, significant difference was noted between the two groups （t = 12. 27, P = 0. 00）. In addition, statistical difference of low-ADC were also noted between the PZs with welldifferentiated cancer 1.04×10^-3 ±0. 20 ×10^-3 mm^2/s and the PZs with poor-differentiated cancer （0. 89Х10^-3±0. 21Х10^-3 mm^2/s） （t =2. 60, P =0. 01 ） , as well as between the PZs with well-differentiated cancer and the negative group （ t =5.91, P =0.00）. The area under the ROC curve was 0. 95 （P =0.00） ; the best threshold of low-ADC for the diag- nosis of prostate cancer was 1.15Х 10^-3 mm^2/s, the diagnostic sensitivity and specificity were of 85.4% and 92.0% , respectively. Conclusion The values of low-ADC in PZS are useful in diagnosing prostate cancer. The low-ADC less than 1.15 Х 10^-3 mm^2/s is a preferable threshold to differentiate prostate cancer from non cancerous tissue in our study.
出处
《癌症进展》
2012年第2期187-191,共5页
Oncology Progress
关键词
磁共振成像
扩散加权成像
前列腺癌
magnetic resonance imaging diffusion weighted MR imaging prostate cancer
