磁共振T2加权成像联合弥散加权成像对前列腺癌包膜外扩散的预测价值  

Predictive value of T2 weighted imaging combined with diffusion magnetic resonance imaging for extracapsular extension in patients with prostate cancer

作　　者：张立涛[1] 李秀娟[1] 韩耀启[1] 朱晓琳[1] 谢元忠[1] 

机构地区：[1]泰山医学院附属泰安市中心医院医学影像部,271000

出　　处：《中华诊断学电子杂志》2016年第4期226-230,共5页Chinese Journal of Diagnostics(Electronic Edition)

摘　　要：目的回顾性评估磁共振T2加权成像(T2WI)联合弥散加权成像(DWI)对前列腺癌(PCa)包膜外扩散(ECE)的预测价值。方法 60例术前行3.0T磁共振检查的PCa患者,依据影像资料和病理组织学检查结果,将患者分为ECE组和无ECE组。由2名影像学诊断医师对磁共振T2WI和T2WI联合DWI图像进行分析,评估PCa的ECE情况,并测量ECE组和无ECE组表观弥散系数(ADC)值,比较PCa ECE组和无ECE组的ADC值差异性。本研究经泰安市中心医院医学伦理委员会审核通过。结果磁共振T2WI和T2WI联合DWI的敏感度与特异度分别为76.1%、84.3%。ROC分析显示,磁共振T2WI联合DWI曲线下面积明显大于磁共振T2WI曲线下面积(Az=0.892,0.803,Z=4.661,P<0.01)。ECE组ADC值[(0.72±0.14)×10^(-3)mm^2/s]明显低于无ECE组[(0.94±0.21)×10^(-3)mm^2/s](t=3.82,P<0.01)。结论磁共振T2WI联合DWI图像能够提高预测PCa患者ECE情况,ADC值对评估有无ECE具有重要参考价值。Objective To explore the value of T2-weighted imaging （T2WI） combined with diffnsion-magnetic resonance imaging （DWI） for the prediction of extracapsular extension （ECE） in patients with prostate cancer （PCa）.Methods Sixty patients with PCa who underwent 3T MRI were divided into ECE group and no ECE group according to imaging data and pathological histology.Pictures of T2WI alone and T2WI combination with I）WI were analyzed by two experienced imaging physicians, and apparent diffusion coefficient （ADC） values of tumor were measured, furthemore compared between two groups. Results The sensitivity and specificity of T2WI combined with DWI were 76.1% and 84.3%, respectively, which were superior to those of T2WI alone.The area under the curve （Az） of T2WI combined with DWI on receiver operating characteristic analysis was significantly higher than that of T2WI alone （ Az = 0.892, 0.803, Z =4.661, P 〈0.01 ）.The mean ADC value was significantly lower in patients with ECE [ （0.72±0.14）×10^-3mm^2/s] than that in patients without ECE [ （0.94±0.21）×10^-3mm^2/s] （t = 3.82, P 〈0.01 ）. Conclusions T2WI combined with DWI enhances the potential for predicting ECE status in patients with PCa.ln addition,ADC value has important value to assess patients with or without ECE.

关 键 词：前列腺肿瘤 磁共振成像 弥散 T2加权成像 包膜外扩散 

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]