摘要
目的 探讨基于弥散加权成像(DWI)、T_(2)^(*)弛豫时间定量成像(T_(2)^(*)mapping)及磁敏感加权成像(SWI)的多模态磁共振成像(MRI)在前列腺癌(PCa)与前列腺增生(BPH)鉴别诊断中的应用价值。方法 回顾性纳入PCa患者35例作为PCa组,BPH患者45例作为BPH组。所有患者行前列腺常规MRI及DWI、T_(2)^(*)mapping、SWI检查,分别获取表观扩散系数(ADC)值、T_(2)^(*)值及钙化灶、微出血灶数量。比较两组各参数差异,采用多元Logistic回归构建联合诊断模型,绘制受试者工作特征(ROC)曲线评价各参数单独及联合模型的鉴别诊断效能。结果 PCa组ADC值、T_(2)^(*)值均低于BPH组,微出血灶数量高于BPH组(P均<0.05);两组钙化灶数量比较差异无统计学意义(P>0.05)。基于ADC值、T_(2)^(*)值及微出血灶数量分别构建单一参数诊断模型,其ROC曲线下面积(AUC)分别为0.930、0.866及0.661。采用多元Logistic回归分析构建的ADC值+T_(2)^(*)值联合模型及ADC值+T_(2)^(*)值+微出血灶数量联合模型AUC均为0.961,两种联合模型的AUC均优于单独ADC值模型及单独T_(2)^(*)值模型(P均<0.05)。结论 基于DWI、T_(2)^(*)mapping及SWI的多模态磁共振成像可提高前列腺癌与前列腺增生的鉴别诊断能力,其中DWI与T_(2)^(*)mapping的联合应用表现出较高的诊断价值。
Objective To investigate the value of multimodal magnetic resonance imaging(MRI)combining diffusion-weighted imaging(DWI),T_(2)^(*) relaxation time quantitative imaging(T_(2)^(*) mapping),and susceptibility-weighted imaging(SWI)in the differential diagnosis of prostate cancer(PCa)and benign prostatic hyperplasia(BPH).Methods Thirty-five patients with PCa were retrospectively enrolled as the PCa group,and 45 patients with BPH were enrolled as the BPH group.All patients underwent conventional prostate MRI,DWI,T_(2)^(*) mapping,and SWI.The apparent diffusion coefficient(ADC)value,T_(2)^(*) value,and the number of calcifications and microhemorrhages were obtained.Differences in these parameters between the two groups were compared.A multivariate Logistic regression model was constructed to develop a combined diagnostic model.Receiver operating characteristic(ROC)curves were plotted to evaluate the diagnostic efficacy of each individual parameter and the combined models.Results The ADC and T_(2)^(*) values in the PCa group were significantly lower than those in the BPH group,while the number of microhemorrhages was significantly larger in the PCa group(all P<0.05).No statistically significant difference was found in the number of calcifications between the two groups(P>0.05).Single-parameter diagnostic models based on ADC value,T_(2)^(*) value,and the number of microhemorrhages yielded areas under the ROC curve(AUCs)of 0.930,0.866,and 0.661,respectively.The combined model incorporating ADC and T_(2)^(*) values and the combined model incorporating ADC value,T_(2)^(*) value,and the number of microhemorrhages,both constructed using multivariate Logistic regression analysis,achieved an AUC of 0.961.The AUCs of both combined models were superior to those of the individual ADC value model and the individual T_(2)^(*) value model(both P<0.05).Conclusions Multimodal MRI combining DWI,T_(2)^(*) mapping,and SWI can improve differentiation between PCa and BPH.The combined application of DWI and T_(2)^(*) mapping demonstrates high diagnostic value.
作者
辛玉静
刘青
李晶
XIN Yujing;LIU Qing;LI Jing(Radiology Department,Tianjin Beichen Hospital,Tianjin 300400,China)
出处
《山东医药》
2026年第2期118-121,126,共5页
Shandong Medical Journal
基金
天津市北辰区科技计划项目(SHGY-2023006)。
关键词
前列腺癌
前列腺增生
多模态磁共振成像
弥散加权成像
T_(2)^(*)弛豫时间定量成像
磁敏感加权成像
prostate carcinoma
benign prostatic hyperplasia
multimodal magnetic resonance imaging
diffusionweighted imaging
T_(2)^(*)relaxation time quantitative imaging
susceptibility-weighted imaging
