3.0T MR多高b值DWI对前列腺癌诊断及与Gleason分级相关性分析  

Diagnostic value of 3.0T MR multi high-b-value DWI in prostate cancer and its correlation with Gleason classification

作　　者：王俊[1] 卢环[1] 刘少强[1] 郭少华[1] 许红雨[1] 苏子慧[1] WANG Jun;LU Huan;LIU Shaoqiang;GUO Shaohua;XU Hongyu;SU Zihui(Department of Radiology, the First Affiliated Hospital of Gannan Medical College, Ganzhou 341000,China)

机构地区：[1]赣南医学院第一附属医院影像科,江西赣州341000

出　　处：《实用放射学杂志》2018年第5期730-732,739,共4页Journal of Practical Radiology

摘　　要：目的 探讨3.0T MR超高场强多高b值扩散加权成像（DWI）对前列腺癌（PCa）的诊断价值并分析其与Gleason分级相关性。方法 收集经手术及病理证实的病例78例，其中前列腺增生（BPH）41例、PCa 37例。PCa患者根据术后病理评分分级，分析其与表观扩散系数（ADC）值相关性。所有患者均采用飞利浦3.0T MR进行 b值为0 s/mm2、1 000 s/mm2、1 500 s/mm2参数扫描，比较2种高b值下PCa、BPH信号强度与ADC值，并分析ADC值与Gleason分级相关性。结果 T2WI结合b值为1 500 s/mm2对PCa诊断特异性、准确率高于T2WI结合b值为1 000 s/mm2。PCa术后Gleason评分为2~4分的ADC值＞5~6分的ADC值＞7分的ADC值＞8~10分的ADC值，且相对应病灶b值为1 500 s/mm2的ADC值小于为b值为1 000 s/mm2的ADC值，两者有统计学差异（P＜0.05）。结论 高场强下高b值DWI结合T2信号对PCa及BPH有较高的鉴别诊断价值，且b值增高PCa、BPH特异性及准确性明显提高。ADC值与Gleason评分分级呈负相关。Objective To investigate the diagnostic value of 3.0T MR high field high-b-value diffusion weighted imaging （DWI） in prostate cancer （PCa） and to analyze its correlation with Gleason classification.Methods A total of 78 cases proved by operation and pathology were collected, including 41 cases of benign prostatic hyperplasia（BPH） and 37 cases of PCa. PCa patients were classified according to postoperative pathological scores, and their correlation with ADC values was analyzed subsequently. Parameter scanning was performed in all patients by using Philps 3.0T MR with b value at 0s/mm2 , 1 000 s/mm2 and 1 500 s/mm2.The signal intensity and ADC value of PCa and BPH were compared under two kinds of high-b-values, and the correlation between ADC value and Gleason classification was analyzed.Results It was found that the specificity and accuracy of T2WI combined with b value of 1 500 s/mm2 were higher than these of T2WI combined with b value of 1 000 s/mm2 for the diagnosis of PCa. The ranking result of ADC value corresponding to Gleason score of PCa after operation was： 2-4 points 〉5-6 points 〉7 points 〉 8-10 points. Besides, the ADC value of the corresponding lesion with b value of 1 500 s/mm2 was lower than that with b value of 1 000 s/mm2 , and the difference was statistically significant （P〈0.05）.Conelusion High field high-b-value DWI combined with T2WI is of high value in differential diagnosis of PCa and BPH,and the specificity and accuracy of PCa and BPH improve obviously with the increase of the b value.Additionally, the ADC value is negatively correlated with the Gleason score.

关 键 词：前列腺癌 高b值 扩散加权成像 GLEASON评分 

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