DWI在前列腺癌诊断中的价值及其ADC值与Gleason评分相关性研究  

Diffusion weighted imaging in prostate cancer and correlation between apparent different coefficient and Gleason scores

作　　者：魏逸[1] 翟建[1] 

机构地区：[1]皖南医学院第一附属医院弋矶山医院影像中心,安徽芜湖241001

出　　处：《皖南医学院学报》2017年第2期165-169,共5页Journal of Wannan Medical College

摘　　要：目的:探究多b值DWI在前列腺癌诊断中的价值,选取其中最佳b值DWI的ADC值,分析其与前列腺癌病理Gleason评分的相关性。方法:挑选前列腺癌患者28例和前列腺增生患者35例,所有患者均经病理证实,均行常规MRI序列、三种b值(700 s/mm2、1000 s/mm2、1500 s/mm2)的DWI序列、动态增强序列扫描,参照前列腺癌组DWI高信号区、前列腺增生组T2WI增生结节选取感兴趣区,比较前列腺癌组三种b值ADC值相互间的差异,比较前列腺癌组、前列腺增生组之间同一b值ADC值的差异,采用ROC曲线比较三种b值ADC值诊断效能的大小,选取其中最佳b值的ADC值,分析其与前列腺癌病理Gleason评分的相关性。结果:b值为700 s/mm2、1000 s/mm2、1500 s/mm2时前列腺癌的ADC值大小分别为(0.876±0.192)×10-3mm2/s、(0.809±0.179)×10-3mm2/s、(0.697±0.155)×10-3mm2/s,前二者分别与后者之间差异有统计学意义,但前二者之间差异无统计学意义,ROC曲线分析示三种b值ADC值鉴别前列腺癌与前列腺增生的曲线下面积分别为0.986、0.988、0.992,b值为1500 s/mm2时ADC值诊断效能最佳,其ADC值诊断阈值为1.026×10-3mm2/s,其灵敏度和特异度分别为92.9%和100%,b=1500 s/mm2时所测ADC值与前列腺癌病理Gleason评分有统计学相关关系,相关系数为-0.390。结论:不同b值下的ADC值对前列腺癌的诊断有一定的影响,b值为1500 s/mm2时ADC值的诊断效能最佳,前列腺癌的ADC值与病理Gleason评分呈负相关,ADC值能够在一定程度上反映肿瘤的恶性程度。Objective：To assess the value of multi-b factor in diffusion weighted imaging（DWI） in diagnosis of prostate cancer,and to analyze the correlation of apparent different coefficient（ADC） with Gleason grading system through determining the optimal b-value in DWI.Methods：Twenty-eight patients with prostate cancer and 35 with benign prostatic hyperplasia（BPH） were included in this study.All cases received pathological confirmation,and undergone DWI scanning as conventional MRI sequence and different b-value（700 s/mm^2,1000 s/mm^2 and 1500 s/mm^2） and dynamically enhanced scanning.High signal DWI at the prostate cancer group and T2WI in the hyperplastic nodule at region of interest were selected as reference to compare the difference of the three b-values and ADC within the prostate cancer group as well as the difference at identical b-value and ADC in the groups of prostate cancer and prostatic hyperplasia.Receiver operating characteristic（ROC） curve was used to analyze and compare the diagnostic performance of the three b-values in ADC.Optimal b-value in ADC was determined and its relationship with Gleason scores was analyzed.Results：b-value at 700 s/mm^2,1000 s/mm^2 and 1500 s/mm^2 led to ADC by （0.876±0.192）mm^2/s,（0.809±0.179）mm^2/s and （0.697±0.155）mm^2/s,respectively.The former two groups were different from the third group,yet the former two groups had no statistical difference.ROC curve analysis indicated area under the curve as 0.986,0.988 and 0.992,respectively,in the three ADC values,and b-value in ADC at 1500 s/mm^2 had the best diagnostic performance.The diagnostic threshold of ADC was （1.026×10^-3）mm^2/s,and the sensitivity and specificity were 92.9% and 100%,respectively.ADC value measured as b=1500 s/mm^2 had statistical correlation with Gleason score for prostate grading（correlation coefficient：-0.390）.Conclusion：ADC under different b-factor may produce certain effects on the diagnosis of prostate cancer,and ADC in b=1500 s/mm^2 has the best diagno

关 键 词：ADC 前列腺癌 B值 GLEASON评分 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学]