扩散峰度成像联合体素内不相干运动成像对前列腺癌的诊断及鉴别诊断价值  

The value of DKI combined with IVIM in the diagnosis and differential diagnosis of prostate cancer

作　　者：王睿 仲津漫 汪洋 杨如武 赵明增 任小军 王双双 范颖 任静 WANG Rui;ZHONG Jinman;WANG Yang;YANG Ruwu;ZHAO Mingzeng;REN Xiaojun;WANG Shuangshuang;FAN Ying;REN Jing(Department of Radiology,Xijing Hospital,the Air Force Medical University,Xi＇an 710032,China;Department of Radiology,XD Group Hospital,Xi＇an 710077,China)

机构地区：[1]空军军医大学西京医院放射科,陕西西安710032 [2]西电集团医院放射影像科,陕西西安710077

出　　处：《实用放射学杂志》2018年第9期1397-1400,共4页Journal of Practical Radiology

基　　金：国家自然科学基金项目（81370039）；陕西省卫生科研基金项目（2016D070）。

摘　　要：目的 探讨扩散峰度成像（DKI）联合体素内不相干运动（IVIM）成像在前列腺癌（PCa）的诊断和鉴别诊断及其在评估PCa侵袭性中的价值。方法 回顾性分析经穿刺活检或手术病理证实的53例前列腺病变，其中PCa 23例，前列腺增生（BPH）30例。所有患者均行前列腺常规MRI、DKI及IVIM扫描，获得病灶的纯水分子扩散系数（D）、快速水分子扩散系数（D＊）、灌注分数（f）以及平均扩散峰度（MK）、平均扩散系数（MD）和各向异性分数（FA）值，采用受试者工作特征曲线（ROC曲线）评估各参数对BPH及PCa的鉴别诊断效能，并分析其在PCa不同Gleason评分间的差异，P〈0.05为差异有统计学意义。结果 BPH和PCa组间MK，MD，D，f值的差异均有统计学意义（P值均为0.000）。IVIM模型的D值与DKI模型的MK、MD值之间存在显著相关性（r值分别为-0.752和0.781），P值均为0.000。ROC曲线分析示MK值诊断效能最大，曲线下面积（AUC）=0.98。联合D值和MK值的AUC为0.99。不同Gleason评分组间（6，7及≥8）的MK值差异有统计学意义（P=0.005），MD、D及f值无统计学意义（P〉0.05）。结论 IVIM模型中的D值和DKI模型中的MK值诊断敏感性和特异性较高，两者联合诊断效能更高，有助于BPH及PCa的鉴别诊断。DKI模型中的MK值有助于PCa病理分级。Objective To investigate the value of diffusion kurtosis imaging （DKI） combined with intravoxel incoherent motion （IVIM） in the diagnosis and differential diagnosis of prostate cancer （PCa）and in evaluating its invasion.Methods A total of 53 cases of prostate lesions confirmed by biopsy or surgical histopathology were included in the retrospective study,including 23 cases of PCa and 30 cases of benign prostatic hyperplasia（BPH）.Before treatment, all patients underwent MRI scans with sequecces of T2WI, DCE-MRI,DKI and IVIM.The parameters of pure diffusion coefficient （D）, pseudodiffusion coefficient （D＊）, perfusion fraction （f）, mean kurtosis （MK）,mean diffusivity （MD） and fractional anisotropy （FA） were calculated and compared between two groups of BPH and PCa.The receiver operating characteristic （ROC） curve was used to assess the diagnosis efficiency of each parameter in IVIM and DKI models.The correlation between these parameters and Gleason scores of prostate lesions was also analyzed.P〉0.05 was considered to be statistically significant.Results The differences in MK,MD,D and f between BPH and PCa groups were statis- tically significant （P = 0.000）.There was a significant correlation between the D value of the IVIM model and the MK and MD values of the DKI model （r =- 0.752 and 0.781, respectively, P =0.000）.ROC analysis showed that the diagnostic efficiency of MK value was the highest （AUC= 0.98）.The AUC value of combined D value and MK value was 0.99. MK values were statistically significant among different gleason scores （ 6,7 and ≥8） （ P = 0.005 ） , while MD, D and f values all wete not statistically significant （ P 〉 0.05 ）. Conclusion The sensitivity and specificity of combined of D value in IVIM model and MK value in DKI model are much higher than other parameters in differential PCa.The MK value in the DKI grading of PCa. diagnosis between BPH and model can be helpful for the

关 键 词：前列腺增生 前列腺癌 扩散峰度成像 体素内不相干运动 

分 类 号：R597.3[医药卫生—内科学] R737.25[医药卫生—临床医学]