磁共振eDWI技术在中央腺体前列腺癌与前列腺增生鉴别诊断中的价值  

The value of differentiating the central gland cancer from prostatic hyperplasia by eDWI

作　　者：任慧鹏[1] 范晴[1] 霍敏华[1] 王晓虎[1] 吴博云 任转勤 REN Huipeng;FAN Qing;HUO Minhua;WANG Xiaohu;WU Boyun;REN Zhuanqin(Department of Medical Imaging,Baoji Central Hospital,Baoji,Shaanxi Province 721008,China)

机构地区：[1]宝鸡市中心医院医学影像科,陕西宝鸡721008

出　　处：《实用放射学杂志》2020年第10期1625-1630,共6页Journal of Practical Radiology

摘　　要：目的探讨MR增强扩散加权成像(eDWI)技术在中央腺体前列腺癌(CG-PCa)与前列腺增生(BPH)鉴别诊断中的价值。方法收集经病理证实的CG-PCa 32例(CG-PCa组)及BPH 35例(BPH组),所有患者均行常规序列、常规DWI、eDWI(包括多b值DWI、DKI)序列扫描,并测量常规DWI(ADC)、IVIM-DWI[慢速表观扩散系数(ADCslow)、快速表观扩散系数(ADCfast)、快速灌注分数(Ffast)]、拉伸指数DWI模型(SEM)[分布扩散系数(DDC)、拉伸指数(α)]、DKI[平均扩散系数(MD)、轴向扩散系数(Da)、径向扩散系数(Dr)、峰度各向异性(FAK)、平均峰度(MK)、轴向峰度(Ka),径向峰度(Kr)]等序列的参数值,采用独立样本t检验比较2组间诸参数值的差异,采用配对样本t检验比较CG-PCa、BPH组内ADC值与ADCslow及DDC值的差异,并用ROC曲线评价诸参数值鉴别诊断CG-PCa和BPH的效能,用Z检验比较各参数值间的AUC。结果ADC、ADCslow、DDC、α、MD、Da、Dr、MK、Ka、Kr值在CG-PCa与BPH组间有统计学差异(P均<0.01);2组间ADCfast、Ffast、FAK无统计学差异(P均>0.05)。MK、Kr、DDC、ADCslow、Dr、Da、MD、Ka、ADC值的诊断效能均较高(AUC均>0.9),其中Kr、DDC、ADCslow、Dr、Da、MD、Ka值的AUC略大于ADC值(P均<0.05),MK值的诊断效能最大(AUC=0.995)且优于ADC值(Z=1.96,P=0.04)。结论eDWI技术中多个参数有助于鉴别诊断CG-PCa和BPH,其中MK值的诊断效能优于ADC值,eDWI技术表现出较常规DWI序列更多优势。Objective To investigate the value of MR enhanced diffusion weighted imaging(eDWI)in differential diagnosis between central gland prostate cancer(CG-PCa)and benign prostatic hyperplasia(BPH).Methods 32 cases of CG-PCa(CG-PCa group)and 35 cases of BPH(BPH group)confirmed by pathology were collected.All patients underwent routine sequence,conventional DWI,eDWI(including multi-b value DWI,DKI)sequence scanning,and conventional DWI(ADC),IVIM-DWI(ADCslow,ADCfast,Ffast),stretched exponential DWI model(DDC,α),DKI(MD,Da,Dr,FAK,MK,Ka,Kr)were measured.t-test of independent samples was used to compare the differences of parameters between the two groups,paired sample t-test was used to compare the differences of ADC with ADCslow and DDC in CG-PCa and BPH groups,and ROC curve were performed to assess the differential diagnosis efficiency of various parameters,the AUC was compared between parameter values with Z-test.Results The values of ADC,ADCslow,DDC,α,MD,Da,Dr,MK,Ka and Kr were significantly different between CG-PCa and BPH groups(all P<0.01),but there were no significant differences in ADCfast,Ffast and FAK between the two groups(all P>0.05).The diagnostic efficiency of MK,Kr,DDC,ADCslow,Dr,Da,MD,Ka and ADC values were all higher(AUC>0.9).The AUC values of Kr,DDC,ADCslow,Dr,Da,MD and Ka values were slightly higher than those of ADC values(all P<0.05).The diagnostic efficiency of MK values was the highest(AUC=0.995)and better than that of ADC values(Z=1.96,P=0.04).Conclusion Multiple parameters from eDWI technology are helpful to differentiate CG-PCa from BPH.The diagnostic efficiency of MK value is better than ADC.The eDWI technology shows more advantages than conventional DWI sequence.

关 键 词：前列腺癌 前列腺增生 磁共振成像 扩散加权成像 

分 类 号：R737.25[医药卫生—肿瘤] R697[医药卫生—临床医学]