MRI多参数成像技术在前列腺癌患者诊断中的应用  

Application of MRI Multi-parameter Imaging Technology in the Diagnosis of Prostate Cancer Patients

作　　者：杨莉月[1] 耿承军[1] 杨晓亮[1] 

机构地区：[1]中国人民解放军第101医院医学影像科,江苏无锡214000

出　　处：《中国实验诊断学》2017年第11期1907-1911,共5页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨MRI多参数成像技术在前列腺癌(PCA)患者诊断中的应用价值。方法选取2015年3月至2017年4月我院对前列腺病灶行MRI扫描患者60例为研究对象,其中30例经手术或病理证实为前列腺癌,余下30例为前列腺增生,另选取30例健康志愿者为对照组,分析前列腺癌、前列腺增生患者T2加权成像(T2WI)、弥散加权成像(DWI)、动态增强(DCE)表现,比较前列腺癌组、前列腺增生组在b=50s/mm2及b=800s/mm2处DWI信号强度值与表观弥散系数(ADC),对比三组感兴趣区转运常数(Ktrans)、血管外细胞外间隙体积百分数(Ve)、速率常数(Kep)等参数,并分析T2WI、DWI、DCE单独或联合诊断前列腺癌的ROC曲线下面积(AUC)及效能。结果前列腺癌在T2WI上主要呈斑片状、结节状低信号,DWI上见斑片状或结节状高信号,DCE上呈Ⅱ、Ⅲ型曲线;前列腺癌组在b=50s/mm2及b=800s/mm2处信号强度值(90.34±1.67)、(103.29±1.68)及ADC值(101.10±1.67)均低于前列腺增生组、对照组(P<0.05);前列腺癌组DCE上Ktrans(0.34±0.03)min-1、Ve(0.23±0.06)min-1、Kep值(0.72±0.05)大于前列腺增生组、对照组(P<0.05);MRI各参数成像技术中T2WI+DWI诊断前列腺癌的AUC值、灵敏度、准确度较高、特异度最高,分别为0.891、90.90%、77.48%、82.21%。结论 MRI各参数技术应用于前列腺癌中具有较高诊断价值,尤其是T2WI联合DWI可明显提高诊断效能,值得在临床推广应用。Objective To explore the value of MRI multi-parameter imaging in the diagnosis of prostate cancer （PCA） patients. Methods 60 cases of patients performed with MRI scan of prostate lesions in our hospital from March 2015 to April 2017 were selected for the study. 30 cases were confirmed as prostate cancer by surgery or pathology and the remaining 30 cases were benign prostatic hyperplasia. What＇s more the other 30 healthy volunteers were selected to the control group. The T2 weighted imaging （T2WI）, diffusion weighted imaging （DWI） and dynamic contrast-enhanced （DCE） manifestation in patients with prostate cancer or benign prostatic hyperplasia were analyzed. The DWI signal intensity and the apparent diffusion coefficient （ADC） at b=50 s/mm^2 and b=800 s/mm^2 were compared be- tween the prostate cancer group and the benign prostatic hyperplasia group. The region of interest （Ktrans）, vascular and extracellular space volume percentages （Ve）,the rate constant （Kep） and other parameters in the three groups were compared and the area under ROC curve （AUC） and efficacy of the singleness or combination of the T2WI,DWI, and DCE for the diagnosis of prostate cancer. Results Patchy,nodular low signal were mainly showed when prostate cancer was in the T2WI while patchy or nodular high signal were showed in the DWI and type II curve or type III curve were indicated in the DCE. The signal intensity values （90.34 ± 1.67）, （103.29 ± 1.68） and ADC values （101.10 ± 1.67） at b=50 s/mm^2 and b= 800 s/mm^2 in the prostate cancer group were lower than those in the benign prostatic hyperplasia group （P〈0.05）. The levels of Ktrans （0. 34±0.03） min^-1 ,Ve （0. 23±0.06） rain^-1 and Kep （0.72± 0. 05） in DCE in the prostate cancer group were higher than those in the benign prostatic hyperplasia group and the control group （P〈0.05）. The AUC value, sensitivity, specificity and accuracy of T2WI＋DWI by MRI in the diagnosis of prostate cancer were 0. 891%, 90. 90%,

关 键 词：MRI 多参数成像技术 前列腺癌 诊断 

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]