肝脏快速容积采集序列和抑脂扰相梯度回波序列两种方式增强扫描对前列腺癌诊断价值的对比研究  

Comparison of Diagnostic Value of Liver Acquisition with Volume Acceleration and Fat- suppressed Spoiled Gradient Echo Contrast Enhancement for Prostate Cancer

作　　者：刘虎[1] 乔洪梅[1] 沈维英 朱佩云[1] 陈泽鑫[2] 陆忠烈[1] 

机构地区：[1]浙江省嘉兴市第二医院放射科,314000 [2]浙江大学医学院附属第二医院临床流行病和生物统计研究室

出　　处：《中国全科医学》2014年第36期4395-4398,共4页Chinese General Practice

摘　　要：目的比较MRI肝脏快速容积采集序列(LAVA)增强扫描和抑脂扰相梯度回波序列(FS-SPGR)增强扫描对前列腺癌的诊断价值。方法选择2010年6月—2013年10月因血精、血尿、夜尿增多等泌尿系统临床表现在嘉兴市第二医院就诊或实验室检查血清前列腺特异性抗原异常者92例,按随机数字表法决定患者增强扫描序列。采用LAVA增强扫描患者44例,采用FS-SPGR增强扫描患者48例,检查后3个月内进行首次穿刺或手术获得病理资料确诊。应用诊断性试验计算两种增强扫描方式的诊断总符合率、灵敏度、特异度、阳性预测值、阴性预测值、约登指数(Youden指数)、阳性似然比、阴性似然比,采用χ2检验比较差异有无统计学意义。结果 16例患者经LAVA增强扫描诊断为前列腺癌,在增强图像上表现为"快进快出",结节状占位灶在动态增强早期明显强化;16例患者经FS-SPGR增强扫描诊断为前列腺癌,在增强图像上显示占位灶呈不均匀强化。两种方式增强扫描诊断前列腺癌的总符合率、灵敏度、特异度、阳性预测值和阴性预测值比较,差异均无统计学意义(P>0.05)。结论采用LAVA和FS-SPGR两种方式增强扫描诊断前列腺癌准确性相似,但采用LAVA多期动态增强扫描时间较短,两种方式增强扫描对前列腺癌均有较大诊断价值。Objective To analyze the diagnostic value of contrast enhancement by 1iver acquisition with volume acceleration（ LAVA） and fat- suppressed spoiled gradient echo（ FS- SPGR） in prostate cancer detection. Methods A total of 92 patients with abnormal PSA given laboratory examination and urinary system symptoms like hematospermia,hematuresis and increased nocturia admitted to the Second Hospital of Jiaxing from June 2010 to October 2013 were randomly divided into LAVA group（ 44 cases） and FS- SPGR group（ 48 cases）. During the first three months after MRI examination,histopathological results were obtained through biopsy and transurethral resection of the prostate. By applying diagnostic test,the coincidence rate,sensitivity,specificity,positive predictive value,negative predictive value,Youden index,positive likelihood ratio and negative likelihood ratio in the contrast enhancement scanning by LAVA and FS- SPGR were detected,and chi square test was used to analyze the statistical significance of the difference. Results 16 patients by LAVA enhanced scanning were diagnosed with prostate cancer,with enhancing image characterized by ＂ fast forward＂ and the nodular focal placeholder significantly enhanced in the early dynamic stage. 16 patients with FS- SPGR enhancement scanning were diagnosed with prostate cancer, with enhanced image characterized by uneven placeholder. The two methods in the diagnosis of prostate cancer showed no statistically significant difference in coincidence rate,sensitivity,specificity, positive predictive value and negative predictive value（ P〉0. 05）. Conclusion The LAVA and FS- SPGR have similar accuracy in the diagnosis of prostate cancer,but the LAVA multiphase dynamic enhanced scanning has shorter time. Both methods of the enhancement scanning is of great diagnostic value for prostate cancer.

关 键 词：前列腺肿瘤 磁共振成像 肝脏快速容积采集序列 扰相梯度回波序列 诊断试验 

分 类 号：R737.25[医药卫生—肿瘤]