3.0T磁共振高b值扩散加权成像在高龄前列腺癌诊断中的价值  

The value of MRI 3.0T with high b value of diffusion weighted imaging in the diagnosis of prostate cancer

作　　者：王臣[1] 董颖[1] 丁海雍[2] 

机构地区：[1]复旦大学附属华东医院放射科,上海市200040 [2]复旦大学附属华东医院泌尿外科,上海市200040

出　　处：《老年医学与保健》2016年第5期295-297,315,共4页Geriatrics & Health Care

摘　　要：目的评价3.0T磁共振高b值(2 000 s/mm^2)扩散加权成像(diffusion weighted imaging,DWI)在高龄前列腺癌患者诊断中的价值。方法60例前列腺特异抗原(prostate specific antigen,PSA)升高的高龄老年男性患者行穿刺活检,术前采用不同b值行前列腺磁共振DWI检查。结果前列腺穿刺结果显示60例患者中前列腺癌36例,非前列腺癌24例。DWI图上,b=1 000 s/mm^2时,前列腺癌的诊断敏感性为66.7%(24/36)、特异性为66.7%(16/24);b=2000 s/mm^2时,前列腺癌的诊断敏感性为88.9%(32/36)、特异性为91.7%(22/24),两种b值诊断的敏感性、特异性和准确度差异有统计学意义(P<0.05)。而在表观扩散系数(apparent diffusion coefficient,ADC)图上,两种b值诊断的敏感性、特异性和准确度差异无统计学意义。此外,以PSA>30 ng/mL诊断前列腺癌的阳性预测值为100%。结论应用高b值3.0T磁共振有利于高龄老年患者前列腺癌的检出,值得在老年患者中推广应用。Objective To evaluate the value of MRI 3.0T with high b value （2 000 s/mm^2） in the diagnosis of prostate cancer in aged men. Method Chose 60 aged males whose PSA value was greater than normal range to take biopsy of prostate, before the biopsy they have to take MRI DWI examination with different b value. Result 36 people were malignant and 24 people were benign. At the picture of DWI, when b = 1 000 s/mm^2 the sensibility is 66.7 % （24/36）, the specificity is 66.7% （16/24）. When b=2 000 s/mm^2, the sensibility is 88.9% （32/36）, the specificity is 91.7% （22/24）. The difference of sensibility, specificity and accuracy between two b value have statistical significance （P〈0.05）. But at the picture of ADC, the differences of sensibility, specificity and accuracy between two b value have no statistical significance. And when PSA 〉 30 ng/mL, the positive predictive value is 100%. Conclusion Using high b value 3.0T MRI is propitious to the diagnosis of prostate that should be popularized in the old patients.

关 键 词：磁共振成像 扩散加权成像 前列腺肿瘤 

分 类 号：R737.25[医药卫生—肿瘤]