3．0T MR扩散加权成像对前列腺中央腺体癌分化程度的预估价值  

The value of MR diffusion-weighted imaging to predict the cellular differentiation of prostatic central gland cancer

作　　者：李鹏[1] 杨文君[2] 陈志强[3] 郭玉林[3] 杨文静[1] 杜奕[1] 李艳[1] 张俊[1] 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏医科大学基础学院 [3]宁夏医科大学总医院放射科

出　　处：《实用放射学杂志》2013年第4期589-592,共4页Journal of Practical Radiology

基　　金：基金项目：宁夏自然科学基金项目（NZ09110,NZl234）.

摘　　要：目的通过研究前列腺中央腺体癌（central gland prostate cancer，CGPCa）的ADC值与病理Gleason评分的关系，探讨3．0TMR扩散加权成像（DWI）评价CGPCa生物学特性的价值。方法使用3．0TMR扫描仪对经手术或穿刺病理证实的34例CGPCa和34例良性前列腺增生（benign prostatic hyperplasia，BPH）患者行DWI扫描，通过GE4．3工作站进行数据处理获得不同病灶的ADC值，比较2组患者之间ADC值的差异。将癌区ADC值分别与Gleason评分比较，分析是否存在相关性，并绘制ROC曲线，确定ADC值诊断中高分化CGPCa的最佳临界点。结果CGPCa组ADC值为（O．78±0．15）×10。mm。／s，BPH组ADC值为（1．24±0．20）×10。mm。／s，两者有统计学差异（f一10．67，P〈O．01）。CGPCaGleason评分2～6分、7分、8～lO分的ADC值分别为（0．894-0．26）×10。mm。／s、（0．794-0．12）×10。mm。／s、（0．67±0．11）×10。mm2／s，经方差分析有统计学意义（F=8．38，P（O．05）。癌区ADC值与Gleason评分呈负相关（r=一0．56，P〈0．05）。根据ROC分析，当最佳临界点为0．79×10。mm。／s，鉴别中高分化组（Gleason评分≤7分）与低分化组（Gleason评分≥8分）CGPCa的敏感度为60．91％，特异度为90．90％，准确率为70．61％。结论CGPCa的ADC值与Gleason评分具有中等相关性，可以对癌灶的分化程度进行初步评估。Objective By analysis of the relationship between ADC and Gleason score of central gland prostate cancer （CGPCa）, to discuss the value of 3.0T MR DWI in evaluating biological behavior of CGPCa. Methods 3.0T DWI of 34 CGPCa patients and 34 benign prostatic hyperplasia {BPH} proven pathologically were obtained. All of the data were transferred to GE Advanced Work- station 4.3. ADC values of different region of interest{ROI} were calculated and compared respectively. The correlation between ADC value and Gleason score was analysed statistically. ROC curve was used to determine the cutoff ADC value for the moderately differentiated CGPCa detection. Results The mean ADC value in CGPCa group and BPH group were {0.78---t-0. 15）and {1.24-1- 0.20） ）〈 10-3 mmZ/s , respectively（ t= 10.67 ,P^0.01 ）. The mean ADC value with Gleason score 2--6,7 and 8--10 were（ 0.89---t-_ 0.26） ,（0.79：t：0.12} and（0.67-t-0.11} X 10-3 mmZ/s, respectively{F=8.38,P〈i0.05}. There was a negative correlation between ADC value of CGPCa and Gleason score（r=--0.56,P＇~0.05）. According to the ROC analysis, when the cutoff value was 0.79 ）〈 10 3 mmZ/s, the diagnostic sensitivity,specificity and accuracy of the Gleason score^7 and Gleason score^8 were 60.91 ~ ,90. 900//00 and 70.61 ~ respectively. Conclusion The ADC value is mediumly correlated with Gleason score of CGPCa. 3.0T MR DWI may be used to estimate the differentiation of CGPCa.

关 键 词：前列腺肿瘤 扩散加权成像 GLEASON评分 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学]