3.0T扩散加权成像对前列腺中央腺体癌和增生的诊断价值  被引量:14

Value of 3. 0 T MR Diffusion-Weighted Imaging in Differential Diagnosis of Prostatic Central Gland Cancer and Benign Prostatic Hyperplasia

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作  者:李鹏[1] 杨文君[2] 陈志强[1] 刘芸[3] 蔡磊[1] 郭玉林[1] 杜奕[4] 李艳[4] 

机构地区:[1]宁夏医科大学总医院放射科,银川50004 [2]宁夏医科大学基础学院,银川750004 [3]宁夏医科大学心脑血管病医院放射科,银川750004 [4]宁夏医科大学,银川750004

出  处:《临床放射学杂志》2013年第10期1458-1461,共4页Journal of Clinical Radiology

基  金:宁夏自然科学基金资助项目(编号:NZ09110;NZ1234)

摘  要:目的探讨3.0T扩散加权成像(DWI)对前列腺中央腺体癌(CGPCa)和不同类型前列腺增生(BPH)的诊断价值。方法回顾性分析经病理证实的34例CGPCa和70例BPH患者的MRI、DWI资料,分析两组患者的T2WI和DWI表现,并分别测量表观扩散系数(ADC)值。比较两组患者及不同Gleason评分组之间ADC值的差异,并绘制受试者工作特征曲线确定诊断CGPCa的最佳临界点。结果 CGPCa组ADC值为(0.78±0.15)×10-3mm2/s;BPH组中以腺体增生为主型(gBPH)、基质增生为主型(sBPH)和混合型增生(mBPH)的ADC值分别为(1.49±0.11)×10-3mm2/s、(1.12±0.14)×10-3mm2/s和(1.34±0.14)×10-3mm2/s,3种类型增生的平均ADC值为(1.28±0.20)×10-3mm2/s。CGPCa组和BPH组之间ADC值(平均ADC值)差异有统计学意义(t=13.77,P<0.01)。根据受试者工作特征曲线分析Youden指数最大为0.80,最佳临界点为1.05×10-3mm2/s,此时诊断CGPCa的敏感性为82.90%,特异性为97.10%,准确性为94.32%。中央腺体癌低危组(Gleason评分<7分)和中高危组(Gleason评分≥7分)ADC值分别为(0.89±0.26)×10-3mm2/s和(0.74±0.13)×10-3mm2/s,差异有统计学意义(t=3.09,P<0.01)。结论 DWI有助于CGPCa和不同类型BPH的诊断和鉴别诊断,并可初步评估CGPCa的分化程度。Objective To investigate the value of 3.0T DWI in the differential diagnosis of central gland prostate canc- er(CGPCa) and benign prostatic hyperplasia (BPH). Methods The MRI and DWI imaging dates of 34 cases of CGPCa (positive group) and 70 cases of BPH (negative group)were analyzed retrospectively. MR characteristics of T2WI, DWI and ADC values were compared in two groups. ROC cure was used to determine the cutoff value for the CGPCa detected with the ADC value. Sensitivity and specificity were calculated. Results The mean ADC value of CGPCa group was (0.78 ± 0.15 ) × 10 3mm2/s. The mean ADC value of glandular BPH,stromal BPH and mixture BPH were (1.49 ± 0.11 ) × 10-3 mm2/s, ( 1.12 ±0.14) × 10 -3mm2/s and( 1.34 ±0.14) × 10 3mm2/s respectively. The mean ADC value of three type of BPH was (1.28 ±0.20) × 10 3mm2/s. The mean ADC value had statistically significant difference between two groups( t = 13.77 ,P 〈0.01 ). According to the ROC analysis,when the cutoff value was 1.05 × 10 3mm2/s, the maximal Youdeng index were 0.80, the diagnostic sensitivity, specificity and accuracy was 82.90% ,97.10% and 94.32% respectively. The mean ADC value of the low risk group( Gleason score 〈 7 )and the intermediate and high risk group (Gleason score ≥ 7 ) were (0.89 -±0.26) ×× 10-3mm2/s and (0.74 ±0.13 ) × 10 -3mm2/s ,respectively(t = 3.09 ,P 〈0.01 ). Conclusion DWI is helpful to differential diagnosis of CGPCa and BPH.

关 键 词:前列腺肿瘤 前列腺增生 扩散加权成像 

分 类 号:R445.2[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学]

 

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