MR扩散加权成像表观扩散系数值对前列腺癌诊断及与Gleason评分的相关性  

MR diffusion weighted imaging apparent diffusion coefficient in the diagnosis of prostate cancer and its correlation with Gleason score of malignancy

作　　者：黄松[1] 盛伟华[1] 李烨[1] 阮娇妮 王夷蕾 宋黎涛[1] HUANG Song;SHENG Wei-hua;LI Ye;RUAN Jiao-ni;WANG Yi-lei;SONG Li-tao(Department of Medical Imaging,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501-504,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨磁共振(MR)扩散加权成像(DWI)表观扩散系数值(ADC)对前列腺癌(PCa)诊断及恶性程度Gleason评分的相关性。方法:52例PCa患者和35例前列腺增生(BPH)患者分别记为PCa组和BPH组。所有患者均经根治手术或穿刺病理确诊,术前均接受DWI检查并选择感兴趣区(ROI)测量ADC值,比较单独DWI和DWI+ADC值诊断PCa的敏感度、特异度和准确度,比较BPH和PCa患者、不同Gleason分级PCa患者的ADC值差异,采用Pearman法分析PCa患者的ADC值与Gleason评分的相关性。结果:DWI+ADC诊断PCa的敏感度、特异度和准确度分别为94.23%(49/52)、91.43%(32/35)、93.10%(81/87),分别高于单独DWI诊断PCa的78.85%(41/52)、71.43%(25/35)、75.86%(66/87),差异均有统计学意义(χ2=5.283、4.629、9.864,P<0.05);根据Gleason评分<8分和≥8分将PCa组分为低中危组(n=31)和高危组(n=21),BPH组、低中危组PCa和高危组PCa患者的ADC值依次明显下降,差异有统计学意义(F=9.570,P<0.05),两两比较,低中危组ADC值低于BPH组,高危组ADC值低于低中危组,差异均有统计学意义(t=6.793、5.879,P<0.05);Pearman法分析显示,PCa组ADC值与Gleason评分呈负相关(r=-0.580,P=0.008,P<0.05)。结论:DWI联合ADC值不仅对PCa的诊断价值较好,而且ADC值与Gleason评分呈负相关,对临床评估PCa患者病情恶性程度和预后有一定指导价值。Objective:To investigate the correlation of apparent diffusion coefficient(ADC)of diffusion weighted MR imaging(DWI)in the diagnosis of prostate cancer(PCA)and Gleason s score of malignancy.Methods:52 patients with PCa and 35 patients with BPH were recorded as PCa group and BPH group respectively.All patients were confirmed by radical operation or puncture pathology.Before operation,all patients were examined by DWI and measured ADC value in(region of interest,ROI).The sensitivity,specificity and accuracy of DWI and DWI+ADC value in diagnosing PCA were compared.Different ADC values of PBH patients,PCA patients and PCA patients with different Gleason grades were analyzed.Pearman method was used to analyze the correlation between ADC values and Gleason scores of PCA patients.Results:The sensitivity,specificity and accuracy of DWI+ADC in the diagnosis of PCA were 94.23%(49/52),91.43%(32/35),93.10%(81/87),which were higher than 78.85%(41/52),71.43%(25/35)and 75.86%(66/87)of DWI alone,respectively.The differences were statistically significant(χ2=5.283,4.629,9.864,P<0.05).According to Gleason score<8 or≥8,PCA group was divided into low and medium risk group(n=31)and high-risk group(n=21).The ADC values of PCA patients in BPH group,low,medium and high-risk group decreased significantly in turn(F=9.570,P<0.05).The ADC value of low and medium risk group was lower than that of BPH group,and that of high risk group was lower than that of low and medium risk group(t=6.793,5.879,P<0.05).Pearman analysis showed that the ADC value of PCA group was negatively correlated with Gleason score(r=-0.580,P=0.008,P<0.05).Conclusion:The value of DWI combined with ADC is not only good for the diagnosis of PCA,but also has a negative correlation with Gleason score,which has a significant guiding value for clinical evaluation of the malignant degree and prognosis of PCA patients.

关 键 词：前列腺癌 MR扩散加权成像 表观扩散系数值 诊断价值 GLEASON评分 相关性 

分 类 号：R737.25[医药卫生—肿瘤]