MR动态增强定量参数Ktrans值对前列腺外周带T2WI低信号病灶的鉴别诊断价值  

Study of Ktrans value in differential diagnosis of low T2 WI signal in the peripheral zone of prostate gland

作　　者：朱海滨[1,2] 江柳[1] 杨学东[1] 杜华睿[3] 张珏[3] 王霄英[1] 

机构地区：[1]北京大学第一医院医学影像科,北京100034 [2]北京肿瘤医院放射科 [3]北京大学前沿交叉学科研究院

出　　处：《实用放射学杂志》2012年第12期1838-1841,1851,共5页Journal of Practical Radiology

摘　　要：目的 探讨MR动态增强扫描定量参数Ktrans值对前列腺外周带T2WI低信号的鉴别诊断价值。方法 回顺性收集前列腺MRI外周带T2WI低信号的患者共110例。穿刺活检证实为前列腺癌78例，前列腺炎32例。另取同期前列腺MR检查及前列腺穿刺活检均未见异常的14例患者作为对照组。所有病例均行动态增强MR扫描，并测量外周带T2低信号相应区域的Ktrans值。采用单因素方差分析对前列腺癌组、炎症组和正常外周带组间Ktrans值差异进行比较；判断诊断效能采用ROC分析。结果 前列腺癌组的Ktrans均值为（56．2±45．3）×10^-3min^-1；炎症组及正常外周带组相应的Ktrans均值分别为（20.8±9．3）×10^-3min^-1和（12．1±8．7）×10^-3min^-1。前列腺癌组与炎症组以及癌组与正常外周带组间Ktrans值差异均有统计学意义（P均〈0．05），但是炎症组与正常外周带组Ktrans值差异无统计学意义（P＝0．46）。利用癌区和非癌区相应Ktrans值描绘的ROC曲线下面积为0．83（P〈0．00），最佳临界点为27．8×10^-3min^-1，此时诊断前列腺癌的敏感性为72．8％，特异性为84．4％。结论 前列腺癌组Ktrans值大于炎症组和正常外周带组，结合Ktrans值有助于对外周带肿瘤和炎症的鉴别，但炎症和正常前列腺外周带的Ktrans值有部分重叠。Objective To evaluate the efficacy of Ktrans value in differential diagnosis of low T2 WI signal in the peripheral zone ofprostate gland. Methods MR imaging were studied in 124 cases, in which 78 were confirmed of prostate cancer, 32 were prostatitis, and the other 14 were normal. All carcinomas and prostatitis lesions showed focal hypo-intensity on T2WI MR images, and Ktrans value was measured at the corresponding area from dynamic contrast images. One way ANOVA analysis was used to study the difference of Ktrans value in different group of patients. ROC analysis was performed to study the efficacyof Ktrans in differentia tion of different prostate diseases. Results The average Ktrans of prostatic cancer, prostatitis and the normal proslalic peritoneal zone were （56.2±45.3）×10^-3min^-1, （20.8±9.3）×10^-3min^-1 and （12. 1±8.7）×10^-3min^-1,respectively. Ktrans value was higher （P〈0.05） in cancer compared with those in prostatitis and normal peritoneal zone. However, there were no statistically sig nificant differences between prostatitis and the normal peritoneal zone. The AUC of Ktrans was 0.83（P〈50.00）for differentiation of carcinoma from non carcinoma area. Conclusion Ktrans values may he useful for differentiation of prostatic cancer from prostatitis.

关 键 词：磁共振成像 动态增强成像 容积转换常数 外周带 前列腺 

分 类 号：R445.2[医药卫生—影像医学与核医学] R322.64[医药卫生—诊断学]