DCE-MRI定量参数对早期前列腺癌的应用研究  

Application of quantitative parameters of dynamic contrastenhanced MRI in the diagnosis of early prostate cancer

作　　者：章绪辉[1] 梁文[1] 李欣明[1] 全显跃[1] ZHANG Xu-hui;LIANG Wen;LI Xin-ming;QUAN Xian-yue(Department of Radiology,Zhujiang Hospital,Southern Medical University,Guangzhou 510280,China)

机构地区：[1]南方医科大学珠江医院放射科,广州510280

出　　处：《磁共振成像》2018年第8期607-611,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：广东省科技计划资助项目(编号:2014A020212665)~~

摘　　要：目的探讨磁共振动态增强成像(dynamic contrast enhanced-magnetic resonance imaging,DCE-MRI)定量参数对早期前列腺癌的应用价值,并评价定量参数与微血管密度(microvascular density,MVD)、Gleason评分的相关性。材料与方法收集行前列腺DCE-MRI检查的前列腺疾病患者85例,其中早期前列腺癌49例,前列腺增生36例,在容积转运常数(volume transfer contrast,K^(trans))、速率常数(rate contrast,K_(ep))参数图上取感兴趣区(region of interest,ROI)测量前列腺相应部位的K^(trans)、K_(ep)值。对前列腺癌区、中央腺体增生区和外周带非癌区的各参数值差异采用Kruskal-Wallis H检验,组内两两比较采用MannWhitney U检验;应用受试者工作特征(receiver operator characteristic,ROC)曲线分析各参数值对早期前列腺癌的诊断效能;采用Pearson相关分析各参数值与MVD、Gleason评分的相关性。结果前列腺癌区的K^(trans)、K_(ep)值分别是(0.37±0.15)min^(-1)、(1.29±0.29)min^(-1),中央腺体增生区分别为(0.32±0.12)min^(-1)、(1.20±0.24)min^(-1),外周带非癌区分别为(0.15±0.59)min^(-1)、(0.45±0.18)min^(-1),前列腺癌区、中央腺体增生区与外周带非癌区K^(trans)、K_(ep)值的差异有统计学意义(P<0.05),前列腺癌区与中央腺体增生区K^(trans)、K_(ep)值的差异无统计学意义(P>0.05)。K^(trans)、K_(ep)值对早期前列腺癌的曲线下面积(area under curve,AUC)分别为0.770、0.796。前列腺癌区K^(trans)、K_(ep)值与MVD、Gleason评分均有正相关性(P<0.05)。结论 DCE-MRI定量参数K^(trans)、K_(ep)值对早期前列腺癌有中等的诊断效能,可以鉴别癌区和外周带非癌区,尚不能鉴别癌区和中央腺体增生区。另外,K^(trans)、K_(ep)值可作为早期前列腺癌患者的预后参考指标。Objective:To evaluate the diagnostic value of quantitative parameters of dynamic contrast enhanced-magnetic resonance imaging(DCE-MRI)for early prostate cancer,and evaluate the correlation among quantutative parameters and microvascular density(MVD),Gleason score.Materials and Methods:Eighty-five patients with prostatic diseases,including 49 patients with early prostate cancer and 36 patients with benign prostatic hyperplasia,undergoing DCE-MRI examination were enrolled in the study,region of interest(ROI)were drawn on areas of cancerous foci,hyperplasia in the central gland and noncancerous foci in the peripheral zone to measure the values of volume transfer contrast(Ktrans),rate contrast(Kep).The values of the two parameters in the different tissues were compared with Kruskal-Wallis H and Mann-Whitney U;the diagnosis vallue of each parameter for early prostate cancer was evaluated by receiver operating characteristic(ROC)curve;The correlation between the two parameters and MVD,Gleason score were assessed with Pearson correlation.Results:The values of Ktrans,Kep were(0.37±0.15)min-1,(1.29±0.29)min-1 respectively for cancerous foci,(0.32±0.12)min-1,(1.20±0.24)min-1 respectively for hyperplasia in the central gland and(0.15±0.59)min-1,(0.45±0.18)min-1 respectively for noncancerous foci in the peripheral zone.The values of Ktrans and Kep for cancerous foci and hyperplasia in the central gland obviously higher than those for noncancerous foci in the peripheral zone(P<0.05).The Ktrans and Kep of cancerous foci were not obviously higher than those for hyperplasia in the central gland(P>0.05).The area under curve(AUC)of Ktrans and Kep for early prostate cancer was 0.770 and 0.796 respectively.There were significantly positive correlation among the two parameters and MVD,Gleason score(P<0.05).Conclusions:The values of Ktrans and Kep have moderate value in the diagnosis of early prostate cancer,they can differentiate cancerous foci and peripheral zone noncancerous foci,but not differentiate cancerous foci and centr

关 键 词：前列腺肿瘤 磁共振成像 动态增强 定量参数 

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]