前列腺癌的DCE-MRI与DWI诊断的定量分析  

Quantitative Analysis of DCE-MRI and DWI in Prostate Cancer

作　　者：李军苗[1] 杨登法[1] 华浅近[1] 陈建华[1] 张海涛[2] 吴贵阳[3] Li Junmiao;Yang Dengfa;Hua Qianjin(Department of Radiology,Taizhou City Hospital,Zhejiang 318000,China)

机构地区：[1]台州市立医院放射科,318000 [2]台州市立医院泌尿外科,318000 [3]台州市立医院胃肠外科,318000

出　　处：《医学研究杂志》2019年第1期69-73,共5页Journal of Medical Research

基　　金：浙江省医药卫生科研基金资助项目(面上项目)(2018KY905)

摘　　要：目的分析动态增强磁共振成像(DCE-MRI)联合弥散加权成像(DWI)诊断前列腺癌(PC)的临床价值。方法选择2015年5月～2017年8月来笔者医院诊治疑似PC患者46例为研究对象,分析DCE-MRI联合DWI诊断PC的病理特点及其临床价值。结果 46例患者有24例(52.17%) PC患者,22例(47.83%)良性下前列腺增生(BPH); MR平扫PC为T_2WI上局灶性低信号,T_1WI略低信号,髂骨及盆腔淋巴结转移T_1WI信号高低不均,PC癌灶、髂骨及盆腔淋巴结转移DWI呈较高信号,表观弥散系数(ADC)图呈较明显低信号; PC组患者病灶ADC值低于BPH组,EADC值高于PC组(P<0.05); PC组中TIC曲线Ⅲ型占62.50%明显高于BPH组的13.64%,BPH组中TIC曲线Ⅱ型占63.64%高于PC组的25.00%(P<0.05);两组患者峰值时间(T_(max))、最大增强斜率(MSI)、信号强化率(SER)、容量转移常数(K_(trans))、速率常数(K_(ep))、血管外细胞外液间隙容积比(V_e)比较,差异有统计学意义(P<0.05),而峰值强度(SI peak)、对比剂血浆容积比对比剂(V_p)比较,差异无统计学意义(P>0.05);MR平扫(73.07%)诊断准确率低于MR平扫+DCE-MRI(88.46%)及平扫+DCE-MRI+DWI(92.30%)比较,差异有统计学意义(P<0.05)。结论 DCE-MRI联合DWI可有效鉴别与诊断前列腺疾病,对PC有较高的临床诊断率,同时获得较全面的参数信息,敏感度与特异性高。Objective To analyze the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with diffusion-weighted imaging(DWI)in the diagnosis of prostate cancer(PC).Methods Forty-six patients with suspected PC in our department from May 2015 to August 2017 were selected as the research object.The pathological features and clinical value of DCE-MRI combined with DWI in the diagnosis of PC were analyzed.Results Twenty four patients(52.17%)had PC,22 patients(47.83%)had benign prostatic hyperplasia(BPH).MR plain scan PC was focal low signal on T 2WI,slightly lower signal on T 1WI and lower iliac and pelvic lymph nodes.The level of T 1WI signal was unevenly distributed.The signal intensity of DWI was higher in PC foci.Iliac bone and pelvic lymph node metastasis,and the ADC showed a lower signal.The ADC value of lesion in PC group was lower than that of BPH group,and the value of EADC was higher than that in PC group.There was significant difference in ADC value and EADC between the two groups(P<0.05).In the PC group,the TIC curve typeⅢaccounted for 62.50%,which was significantly higher than the 13.64%of the BPH group.In the BPH group,the TIC curve typeⅡaccounted for 63.64%higher than the PC group 25.00%(P<0.05).The peak time(T max),maximum enhancement slope(MSI),signal enhancement rate(SER),volume transfer constant(K trans),rate constant(K ep),and extravascular extracellular fluid volume ratio(V e)were compared between the two groups(P<0.05),and the peak intensity(SI peak)and the plasma volume of the contrast agent(V p)were not significantly different from those(P>0.05).The diagnostic accuracy of MR plain scan(73.07%)was lower than that of MR plain scan+DCE-MRI(88.46%)and plain scan+DCE-MRI+DWI(92.30%,P<0.05).Conclusion DCE-MRI combined with DWI can effectively identify and diagnose prostate diseases,have a higher clinical diagnosis rate for PC,and obtain more comprehensive parameter information with high sensitivity and specificity.

关 键 词：前列腺癌 动态增强磁共振 弥散加权成像 诊断率 

分 类 号：R73[医药卫生—肿瘤]