IVIM-DWI和定量DCE-MRI鉴别前列腺癌和前列腺增生——灌注系数的相关性研究  

Correlation of perfusion fraction between IVIM- DWI and quantitative DCE- MRI for diagnosis of prostate cancer and hyperplasia

作　　者：冷晓明[1] 韩晓蕊[2] 徐嬿[1] 赵曼[2] 刘宇[2] 曾道辉[1] 刘斯润[3] LENG Xiao-ming HAN Xiao-rui XU Yah ZHAO Man LIU Yu ZENG Dao-hui LIU Si-run(Department of Imaging, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangdong 510405, China)

机构地区：[1]广州中医药大学第一附属医院影像科,广东广州510405 [2]广州中医药大学第一临床医学院,广东广州510405 [3]暨南大学附属第一医院影像中心,广东广州510630

出　　处：《影像诊断与介入放射学》2016年第5期390-395,共6页Diagnostic Imaging & Interventional Radiology

摘　　要：目的分析体素内不相干运动磁共振扩散加权成像(IVIM-DWI)和磁共振动态增强扫描(DCE-MRI)定量参数对前列腺癌和前列腺增生鉴别诊断的价值,探讨二者灌注系数的相关性,并对两种不同方法进行评价和比较。方法回顾性分析经病理学证实的31例前列腺癌患者和52例前列腺增生患者。所有患者均行前列腺IVIM-DWI和DCE-MRI检查,其中IVIM-DWI采用10个b值(b=10、20、30、50、80、100、200、400、1000、1500 s/mm^2),将所得图像通过工作站后处理,计算出病变组织的纯水分子扩散系数D值及灌注分数f值;同时将DCE-MRI扫描所得图像利用定量分析软件测量出病灶组织的参数值,即容积转运参数K^(trans)值、速率常数K_(ep)值及血管外细胞外容积分数Ve值。利用两独立样本t检验分别计算各参数在前列腺癌组和增生组间的差异;利用Person相关分析对两种不同检查方法中的灌注系数进行相关性分析;并对有鉴别诊断价值的参数行受试者特性曲线(ROC曲线),评价各参数值的诊断效能。结果前列腺癌组的D值明显低于前列腺增生组,差异有统计学意义(P<0.01);前列腺癌组的f值及K^(trans)、K_(ep)、Ve值明显高于前列腺增生组,差异有统计学意义(P<0.01),且f值与K_(ep)值呈正相关(P<0.05),其相关系数为0.368。对D、f值及Ktrans、Kep、Ve值分别行ROC曲线得出:Kep的曲线下面积(AUC)最大(0.991,P<0.01),相应的敏感度和特异度分别为90.91%、100%。结论 IVIM-DWI和DCEMRI定量分析对前列腺良恶性疾病的诊断及鉴别诊断均有价值,两种不同检查方法的灌注系数呈正相关。DCE-MRI的诊断效能优于IVIM-DWI。Objective To assess the diagnostic value of parameters derived from Intravoxel incoherent motion diffusion-weighted imaging（IVIM-DWI） and dynamic contrast-enhanced（DCE）-MRI in prostate cancer and benign prostate hyperplasia and to explore the correlation of perfusion fraction between IVIM-DWI and DCE-MRI. Methods 83 patients with histologically confirmed prostate cancer（31） and prostate hyperplasia（52） underwent IVIM-DWI and DCE-MRI. The IVIM-DWI was performed with 10 b-values（10,20,30,50,80,100,200,400,1000, and 1500 s / mm2） to calculate the values of D and f. The values of K（trans）, K（ep） and Vewere measured on DCE-MRI. All parameters between prostate cancer and hyperplasia were compared by two independent sample t-test. The correlation of perfusion fraction between the two methods was analyzed by Pearson correlation. The diagnostic performance of different parameters was evaluated by receiver operating characteristic（ROC） curve analysis. Results The D value of prostate cancer was significantly lower than that of hyperplasia（P 0.01）. The values of f and Ktrans, Kep, Vewere significantly higher in cancer than hyperplasia（P〈 0.01）. F and K（ep） were positively correlated（r =0.368）. With ROC curve analysis for the values of D, f,K（trans）, K（ep）, Ve, the area under the ROCcurve of Kepwas 0.991, significantly（P0.01） larger than that of D,f,K（trans）, and Vewith 90.91% diagnostic sensitivity and 100% specificity. Conclusion Both IVIM-DWI and DCE-MRI can improve the differential diagnosis of prostate disease with positive correlation of the perfusion fractions. DCE-MRI has better diagnostic performance than IVIM-DWI.

关 键 词：前列腺癌 前列腺增生 体素内不相干运动磁共振扩散加权成像 磁共振动态增强扫描 

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] R697.3[医药卫生—临床医学]