DCE-MRI定量参数联合ADC值诊断前列腺癌的价值及与血清PSA的相关性分析  

The value of DCE-MRI quantitative parameters combined with ADC value in the diagnosis of prostate cancer and its correlation with serum PSA

作　　者：盛伟华[1] 黄松[1] 李烨[1] 蔡华亮 黄辉[1] 宋黎涛[1] SHENG Wei-hua;HUANG Song;LI Ye;CAI Hua-liang;HUANG Hui;SONG Li-tao(Department of Medical Imaging,the Seventh People s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China)

机构地区：[1]上海中医药大学附属第七人民医院医学影像科,上海200137

出　　处：《川北医学院学报》2020年第3期461-464,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨磁共振动态增强扫描(DCE-MRI)定量参数联合表观扩散系数(ADC)值诊断前列腺癌(PCa)的价值及与血清前列腺特异性抗原(PSA)的相关性。方法:收集72例前列腺病变患者资料,其中35例PCa患者记为PCa组,37例良性前列腺增生(BPH)患者记为BPH组。所有患者均接受前列腺DCE-MRI和扩散加权成像(DWI)检查,比较两组容量转移常数(K trans)、速度常数(K ep)、血管外细胞外间隙容积比(V e)和ADC值,同时采用酶联免疫吸附试验(ELISA)检测并比较两组血清PSA水平,并分析上述DCE-MRI定量参数、ADC值与血清PSA水平的相关性。结果:PCa组DCE-MRI定量参数中K trans、K ep均明显高于BPH组,差异有统计学意义(t=16.665、7.204,P<0.05),两组V e比较,差异无统计学意义(t=1.585,P>0.05);PCa组随b值升高,DWI信号强度随之增加,ADC值表现为低信号;BPH组随b值升高,DWI信号强度变化不显著,ADC值表现为高信号。PCa组不同b值DWI信号强度和ADC值均低于BPH组,差异有统计学意义(t=8.206、2.547、7.863,P<0.05),两组血清PSA均呈阳性表达,组间差异无统计学意义(P>0.05);Pearman法分析显示,PCa组K trans、K ep与血清PSA水平呈正相关(r=0.49、0.62,P<0.05),ADC值与血清PSA水平呈负相关(r=-0.47,P<0.05),BPH组上述DCE-MRI定量参数和ADC值与血清PSA水平无相关性(P>0.05)。结论:PCa和BPH患者DCE-MRI定量参数K trans、K ep和ADC值有显著差异,且PCa患者上述指标与血清PSA有显著相关性,K trans、K ep联合ADC值可为临床诊断PCa和鉴别BPH提供有效参考。Objective:To investigate the value of quantitative parameters combined with apparent diffusion coefficient(ADC)of dynamic contrast-enhanced MRI(DCE-MRI)in the diagnosis of prostate cancer(PCa)and its correlation with serum prostate specific antigen(PSa).Methods:72 patients with prostatic diseases were selected,among them,35 PCa patients were recorded as PCa group,37 BPH patients as BPH group.All patients were examined by DCE-MRI and DWI.The volume transfer constant(K utras),velocity constant(K ep),extracellular space volume ratio(V e)and ADC were compared between the two groups.At the same time,the serum PSA level of the two groups was detected and compared by enzyme-linked immunosorbent assay(ELISA),and the correlation between the above quantitative parameters of DCE-MRI,ADC value and serum PSA level was analyzed.Results:In the quantitative parameters of DCE-MRI,K utras and K ep in PCA group were significantly higher than those in BPH group(t=16.665,7.204,P<0.05).There was no significant difference in V e between the two groups(t=1.585,P>0.05).With the increase of b value,DWI signal intensity increased in PCa group,and ADC value showed low signal.With the increase of b value,DWI signal intensity did not change significantly in BPH group,and ADC value showed high signal.The DWI signal intensity and ADC value of different b values in PCa group were lower than those in BPH group,the difference was statistically significant(t=8.206,2.547,7.863,P<0.05),PSa was positive in both groups,there was no significant difference between them(P>0.05).Pearman analysis showed that K utras and K ep in PCA group were positively correlated with serum PSA level(r=0.49,0.62,P<0.05),ADC value was negatively correlated with serum PSA level(r=-0.47,P<0.05),and the above quantitative parameters of DCE-MRI and ADC value in BPH group were not correlated with serum PSA level(P>0.05).Conclusion:The quantitative parameters of DCE-MRI in PCa and BPH patients have significant differences in the values of K utras,K ep and ADC,and the above indexe

关 键 词：前列腺癌 磁共振动态增强扫描 表观扩散系数 诊断 血清前列腺特异性抗原 

分 类 号：R737.25[医药卫生—肿瘤]