DWI 双指数模型参数与前列腺癌 Gleason 评分及临床侵袭性相关性研究  

A study of relationship between biexponential parameters and Gleason score,clinical risk score for prostate cancer

作　　者：王晴[1] 张玉东[1] 武晨江[1] 刘希胜[1] 王小宁[1] 施海彬[1] 孙涛[1] 荣凡令[1] 

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029

出　　处：《实用放射学杂志》2015年第2期258-261,共4页Journal of Practical Radiology

基　　金：国家自然科学基金资助项目（81301191）.

摘　　要：目的：研究多 b值DWI双指数模型参数预测前列腺癌恶性程度的应用价值。方法回顾性分析57例经穿刺或手术证实为前列腺癌患者的多 b 值 DWI（b 值0-800 s/ mm^2）图像,逐层勾画全肿瘤感兴趣区,利用体素不相干运动（IVIM）计算肿瘤扩散系数 Dt、灌注系数 Dp 及灌注分数 f。根据 Gleason 评分（GS）及 D’Amico 分级分组,采用 ANOVA 方差分析及 Spearman 相关分析,低侵袭及中-高侵袭组间行受试者工作特征（ROC）分析。结果癌灶 Dt 在 GS 及 D’Amico 组间存在显著差异且呈负相关。Dp及 f 组间无统计学意义。对 Dt 进行 ROC 分析,敏感性、特异性分别为82.2%,100%；85.1%,90.0%；AUC=0.928,0.838；界值分别为1.073×10^-3 mm^2/s,1.117×10^-3 mm^2/s。结论Dt 可预测前列腺癌恶性程度。Dp 及 f 与前列腺癌恶性度无相关性。Objective To investigate the clinical value of parameters based on intra-voxel incoherent motion （IVIM）-weighted MR Imaging in the prediction of tumor aggressiveness in patients with prostate cancer.Methods The multiple b-value DW images （max-imum b value,800 s/mm^2 ）of 57 patients with pathology-confirmed prostate cancer were retrospectively analyzed.Entire tumor vol-ume-based IVIM parameters includ diffuse efficient Dt,perfusion coefficients Dp and fraction of perfusion f were obtained by bi-expo-nential model.The parameters were correlated with Gleason and D’Amico clinical risk score.The diagnostic sensitivity,specificity and predictive value of the parameters for classifying a tumor grade were determined by using receiver operating characteristic （ROC） analysis.Results The tumor Dt reflected significant differences between different Gleason grade （F = 1 6.448,P 〈 0.001 ）and D’Amico score （F =10.37,P 〈0.001 ）,respectively.A closely negative correlation was determined between Dt and their Gleason scores （Spearman r =-0.693,P 〈0.001）and D’Amico clinical risk scores （r=-0.545,P 〈0.001）.ROC analysis of Dt showed a discriminatory performance of AUC = 0.928 in discerning GS ≤ 6 vs.GS ≥ 7,sensitivity and specificity were 82.2% and 100%（threshold of 1.073× 10^-3 mm^2/s）.AUC of distinguishing low-from intermediate-high risk tumor was 0.838,the sensitivity and specificity were 85.1% and 90.0% （threshold of 1.1 1 7 ×10^-3 mm^2/s）.Conclusion The parameter Dt derived from entire tumor volume-based IVIM-DWI is a promising indice for predicting aggressiveness of prostate cancer while the parameters Dp and f are not.

关 键 词：磁共振成像 体素不相干运动 前列腺癌 侵袭性 GLEASON评分 

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]