MR扩散加权成像在早期前列腺癌诊断中的价值  

Evaluation of MR DWI in Diagnosing Early Prostatic Cancers

作　　者：周婷婷[1] 王建良[1] 沈纪芳[1] 单玉喜[2] 张永胜[3] 杨毅[4] 赵文露[4] 沈钧康[4] 

机构地区：[1]昆山市第一人民医院影像科,215300 [2]苏州大学附属第二医院泌尿外科,215004 [3]苏州大学附属第二医院病理科,215004 [4]苏州大学附属第二医院影像科,215004

出　　处：《临床放射学杂志》2014年第7期1035-1039,共5页Journal of Clinical Radiology

基　　金：江苏省卫生科研项目(编号:H200862)

摘　　要：目的评价磁共振扩散加权成像(DWI)在早期前列腺癌诊断中的价值。方法搜集根治术证实的早期前列腺癌患者33例,在术前1个月内行常规磁共振扫描(T2WI)和DWI,由2名放射科医师分析T2WI和DWI图像,以十二分区、五分制法分别对前列腺各个分区出现癌的可能性评分,将所得结果与病理对照,做受试者工作特征(ROC)曲线分析,并对2名医师诊断一致性做Kappa检验。结果 2名医师单独运用DWI诊断早期前列腺癌的敏感度明显高于单独运用T2WI(P≤0.049),T2WI联合DWI诊断敏感度最高。2名医师T2WI联合DWI诊断早期前列腺癌的ROC曲线下面积(Az)高于单独运用DWI(P=0.027,P=0.378)和单独运用T2WI(P<0.001),单独运用DWI诊断的Az值较单独运用T2WI高(P=0.253,P=0.009)。DWI较常规T2WI提高了两位医生诊断一致性,诊断一致性检验的Kappa值从0.612提高到了0.729。结论 DWI提高了常规T2WI对早期前列腺癌的诊断效能,T2WI联合DWI诊断效能更高。Objective To assess the value of MR DWI in diagnosing early prostatic cancers. Methods A total of 33 patients with surgically-proved early prostate cancer were collected. Within one month before prostatectomy routine MRI scanning, including axial T2WI and DWI, was carried out in all patients. Axial T2WI and DWI images were reviewed by two radiologists. By using 12 sub-region classification and 5 sub-region classification methods the possibility of the presence of cancer at each prostatic sub-region was evaluated with scores. The diagnostic sensitivity, specificity and accuracy were calculated. The results were compared with the pathologic findings, and receiver operating characteristic （ROC） curve analysis was conducted. The consistency of diagnosis by the two radiologists was evaluated with Kappa statistics. Results The sensitivity for early diagnosis of prostatic cancer by the two radiologists by simply using DWI was significantly higher than that by simply using T2WI （P≤0. 049）. Combination use of T2WI and DWI carried the highest diagnostic sensitivity. The area under ROC curve （Az） when T2WI and DWI were used together to diagnose the early prostatic cancer by the two radiologists was strikingly larger than that when only DWI was used （P = 0. 027, P = 0. 378）, or when only T2WI was used （ P 〈 0.001 ）. The Az value when only DWI was employed was much higher than that when only T2WI was employed （P = 0. 253, P = 0. 009）. The use of DWI was better than T2WI in improving the diagnosis consistency of the two radiologists, with Kappa value being increased from 0. 612 to 0. 729. Conclusion DWI can improve the diagnostic ability of routine T2WI for the detection of early prostatic cancer. Combination use of DWI and T2WI is more effective in making diagnosis of prostatic cancer. DWI can improve the diagnosis consistency of the two radiologists.

关 键 词：前列腺肿瘤 磁共振成像 

分 类 号：R737.25[医药卫生—肿瘤]