基于体素内不相干运动的MR扩散加权成像对前列腺癌诊断价值的初步研究  

Investigation of prostate cancer using intravoxel incoherent motion MR imaging

作　　者：万红燕[1] 毕芸祺[2] 衣岩[2] 汤群锋[1] 陈静雯[1] 方向明[1] 

机构地区：[1]南京医科大学附属无锡市人民医院影像科,无锡214023 [2]中国人民解放军军事医学科学院科技部,北京100850

出　　处：《磁共振成像》2015年第6期445-449,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金面上项目(编号:81271629);江苏省"六大人才高峰"计划(编号:2014-WSW-062)

摘　　要：目的初步评价基于体素内不相干运动(IVIM)理论的MR扩散加权成像对前列腺癌的诊断价值。材料与方法连续性回顾性分析具有完整临床资料、MR IVIM扩散加权成像检查和穿刺活检病理结果的前列腺癌患者45例及非前列腺癌者13例,IVIM扩散加权成像采用8个b值(0、50、100、150、200、400、600、800 s/mm2),利用软件双指数函数方式计算信号衰减曲线得出纯水分子扩散系数D值、灌注相关扩散系数D*值及灌注分数f值,并且获取各参数图。采用独立样本t检验比较前列腺癌与非癌外周带组织间各值的差异。结果前列腺癌区域的D值、D*值及f值分别为(0.83±0.14)×10-3 mm2/s、(5.88±1.21)×10-3 mm2/s及(14.3±4.7)%,非癌前列腺外周带组织D值、D*值及f值分别为(1.30±0.23)×10-3mm2/s、(6.25±1.10)×10-3 mm2/s及(15.4±3.8)%,其中前列腺癌区域D值明显低于非癌外周带组织,两者之间有统计学差异(P=0.000)。D*值及f值无统计学差异。D值ROC曲线下面积为0.952,敏感性为100%,特异性为66.7%。结论基于MR体素内不相干运动理论MR扩散成像能提供关于前列腺癌组织扩散及灌注方面更多的信息,D值对前列腺癌的诊断具有重要的价值。Objective： To evaluate the diagnostic value of intravoxel incoherent motion diffusion-weighted imaging for prostate cancer. Materials and Methods： Fortyfi ve patients with prostate cancer and 13 patients without prostate cancer underwent magnetic resonance imaging. DWI was performed by using 8 b values（0, 50, 100, 150, 200, 400, 600, 800 s/mm2）. Biexponential fits were applied to diffusion decay curves by special software to calculate pure molecular-based diffusion coeffi cient（D）, pseudo diffusion coeffi cient of perfusion（D＊） and perfusion fraction（f） on the basis of the IVIM model, parameter maps were also calculated for all parameters. Independent samples group t tests were performed to evaluate the statistical signifi cance between cancerous tissue and noncancerous tissue. Results： The D, D＊ and f values in cancerous tissue were（0.83±0.14） ×10^-3 mm2/s,（5.88±1.21）×10^-3 mm^2/s and（14.3±4.7）%, respectively. The D, D＊ and f values in noncancerous tissue were（1.30±0.23）×10^-3 mm^2/s,（6.25±1.10）×10^-3 mm^2/s and（15.4±3.8）%, respectively. The D value was signifi cantly（P=0.000） lower in cancerous tissue. D＊ and f values were not signifi cantly different in both tissues. The area under the receiver operating characteristic-analyses for D value was 0.952, sensitivity and specificity were 100%, 66.7%, respectively. Conclusion： Intravoxel incoherent motion diffusion-weighted imaging may offer additional information about diffusion and perfusion in prostate cancer. Pure molecularbased diffusion coeffi cient（D） has an important value in diagnosing prostate cancer.

关 键 词：前列腺癌 体素内不相干运动 磁共振扩散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R697.3[医药卫生—诊断学]