DWI和DCE-MRI鉴别诊断良恶性前列腺外周带T2WI局灶性低信号病变  

DWI and DCE-MRI in differential diagnosis of benign and malignant peripheral prostate lesions with focal hypointense signal on T2WI

作　　者：李鹏[1,2] 黄英 李艳 高媛媛[3] 刘岭岭 蔡磊[1] 陈志强[1] LI Peng;HUANG Ying;LI Yan;GAO Yuanyuan;LIU Lingling;CAI Lei;CHEN Zhiqiang(Department of Radiology, the General Hospital of Ningxia Medical University, Yinchuan 750004, China;School of Basic Medicine, Ningxia Medical University, Yinchuan 750004, China;Department of No.3 Oncology, Cancer Hospital, the General Hospital of Ningxia Medical University, Yinchuan 750004, China)

机构地区：[1]宁夏医科大学总医院放射科,宁夏银川750004 [2]宁夏医科大学基础医学院,宁夏银川750004 [3]宁夏医科大学总医院肿瘤医院肿瘤内三科,宁夏银川750004

出　　处：《中国介入影像与治疗学》2021年第3期156-160,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：宁夏回族自治区重点研发计划项目(2019BEG03033);宁夏医科大学科学研究基金资助重点项目(XZ2017008)。

摘　　要：目的探讨弥散加权成像(DWI)和动态对比增强MRI(DCE-MRI)鉴别诊断T2WI表现为外周带局灶性低信号的不同病理级别前列腺癌(PCa)与慢性前列腺炎(CP)的价值。方法36例PCa和15例CP经病理证实,且T2WI外周带均表现为局灶性结节样低信号,回顾性分析其ADC值和信号强度-时间(SI-T)曲线类型差异,并绘制ROC曲线评价其诊断效能。结果36例外周带局灶性PCa患者中,中高危PCa亚组20例,低危PCa亚组16例。除低危PCa亚组与CP组ADC值差异无统计学意义(P=0.079)外,其余两两比较ADC值差异均有统计学意义(P均<0.01)。中高危PCa亚组与CP组SI-T曲线类型差异有统计学意义(P=0.013),其余两两比较差异均无统计学意义(P均>0.05)。ADC值诊断外周带局灶性PCa的AUC为0.823[95%CI(0.708,0.938)];以0.94×10^(-3)mm^(2)/s为最佳临界值,ADC诊断外周带局灶性PCa的敏感度为86.70%,特异度63.90%,准确率79.99%。结论DWI的ADC值有助于鉴别前列腺外周带良恶性局灶性病变,但对鉴别诊断前列腺非临床显著癌与CP无显著价值;DCE-MRI的SI-T曲线可鉴别前列腺临床显著癌与CP。Objective To investigate the value of diffusion weighted imaging(DWI)and dynamic contrast enhanced MRI(DCE-MRI)in differential diagnosis of different pathological grade prostate cancer(PCa)and chronic prostatitis(CP)present as peripheral hypointense signal on T2WI.Methods Data of 36 patients with PCa(PCa group)and 15 with CP(CP group)confirmed pathologically and present as peripheral focal hypointense signal on T2WI were retrospectively analyzed.ADC values and signal intensity-time(SI-T)curve types of lesions were compared between groups,and ROC curve was drawn to evaluate their diagnostic efficacy.Results In PCa group,there were 20 cases of middle-high risk PCa(middle-high risk PCa subgroup)and 16 cases of low-risk PCa(low-risk PCa subgroup).Significant differences of ADC values were found(all P<0.01)except for low-risk PCa subgroup and CP group(P=0.079).SI-T curve types were significant different between middle-high risk PCa group and CP group(P=0.013),but not between other group/subgroups(all P>0.05).AUC of ADC value for diagnosis of peripheral zone focal PCa was 0.823[95%CI(0.708,0.938)].Taken 0.94×10^(-3)mm^(2)/s as the optimal cut-off value of ADC,the sensitivity,specificity and accuracy was 86.70%,63.90%and 79.99%,respectively.Conclusion ADC value of DWI was helpful to differential diagnosis of benign and malignant prostate lesions present as peripheral focal hypointense signal on T2WI,but not valuable enough for differential diagnosis of non-clinical prostate cancer and CP,whereas SI-T curve of DCE-MRI could distinguish clinically significant PCa and CP.

关 键 词：前列腺肿瘤 前列腺炎 弥散磁共振成像 诊断 鉴别 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学]