摘要
目的探讨多参数磁共振成像(mp-MRI)检查前列腺癌(PCa)的图像特征及临床诊断价值。方法选取2019年1月至2019年12月秦皇岛市第二医院收治的PCa和良性前列腺增生(BPH)患者的临床资料进行回顾性分析,分为PCa组和BPH组,分别进行T2加权成像(T2WI)、扩散加权成像(DWI)及动态对比增强磁共振成像(DCE-MRI)检查,比较两组患者T2WI图像特征、外周带和移行带表观弥散系数(ADC)值、DCE-MRI图像类型,并对两组患者采用前列腺癌影像报告数据系统(PI-RADS)v2进行评分,采用受试者工作特征(ROC)曲线分析多参数磁共振成像(mp-MRI)各序列对PCa和BPH的鉴别诊断价值。结果PCa组和BPH组T2WI、DWI图像特征存在明显差异,两组外周带ADC值均明显高于移行带(均P<0.05),且PCa组外周带和移行带ADC值均明显低于BPH组(均P<0.05);PCa组和BPH组患者DCE-MRI图像类型差异有统计学意义(P<0.05),PCa组Tmax明显低于BPH组(P<0.05),SImax明显高于BPH组(P<0.05);PI-RADS v2评分结果显示,PCa组和BPH组T2WI和DWI评分差异有统计学意义(均P<0.05),两组DCE-MRI阳性率分别为94.00%和24.00%(P<0.05)。ROC曲线分析结果显示,T2WI、DWI、DCE-MRI及联合诊断PCa和BPH的灵敏度分别为64.0%、76.0%、94.0%和96.0%,特异度分别为90.0%、92.0%、76.0%和84.0%,联合诊断的AUC最大,为0.914。结论mp-MRI各序列对PCa和BPH的检查结果均存在较多差异,结合PI-RADS v2可有效进行鉴别,对提升PCa早期诊断水平具有重要意义。
Objective To study the characteristics and clinical diagnostic value of multiparametric magnetic resonance imaging(mp-MRI)for prostate cancer(PCa).Methods The clinical data of patients with PCa and benign prostatic hyperplasia(BPH)treated in Qinhuangdao Second Hospital from January 2019 to December 2019 were retrospectively analyzed.They were divided into PCa group and BPH group.T2-weighted imaging(T2WI),diffusion weighted imaging(DWI)and dynamic contrast enhanced(DCE)-MRI were performed respectively.The T2WI image characteristics,peripheral band and transitional band apparent diffusion coefficient(ADC)values and DCE-MRI image types were compared between the two groups.Patients in the two groups were evaluated by Prostate Imaging Reporting and Data System(PI-RADS)v2 Score.Receiver operating characteristic(ROC)curve was used to analyze the value of mp-MRI sequences in the differential diagnosis of PCA and BPH.Results There were significant differences in image features of T2WI and DWI between PCa group and BPH group;the ADC values of both patients in peripheral zone were significantly higher than those in transition zone(all P<0.05);the ADC values of PCa patients in peripheral zone and transition zone were significantly lower than those of BPH patients(all P<0.05).There were statistically significant differences in the types of DCE-MRI images in PCa and BPH patients(P<0.05),and the Tmax of PCa patients was significantly lower than that of BPH patients(P<0.05),while the SImax was significantly higher than that of BPH patients(P<0.05).PI-RADS v2 Score showed that there were statistically significant differences in the T2WI and DWI scores between PCa patients and BPH patients(P<0.05),and the positive rates of DCE-MRI in the two groups were 94.00%and 24.00%respectively(P<0.05).ROC curve analysis showed that the sensitivity of T2WI,DWI,DCE-MRI and combined diagnosis of PCa and BPH were 64.0%,76.0%,94.0%and 96.0%respectively,and the specificity were 90.0%,92.0%,76.0%and 84.0%.Conclusions mp-MRI sequences have many differences in PCa and BPH.Combined with RI-RADS v2,it can effectively identify and is of great significance for improving the early diagnosis of PCa.
作者
叶德刚
赵亮亮
马平
Ye Degang;Zhao Liangliang;Ma Ping(Department of Medical Imaging,the Second Hospital of Qinhuangdao,Qinhuangdao 066600,China)
出处
《中国医师杂志》
CAS
2022年第1期64-68,共5页
Journal of Chinese Physician
基金
秦皇岛市科学技术研究与发展计划(201805A150)。
关键词
前列腺肿瘤
前列腺增生
磁共振成像
Prostatic neoplasms
Prostatic hyperplasia
Magnetic resonance imaging
