IVIM-DWI对前列腺癌诊断价值研究  

Study on value of intravoxel incoherent motion diffusion-weighted imaging for diagnosing prostate cancer

作　　者：刘书林 方向军 LIU Shulin;FANG Xiangjun(Department of Imaging,Second Affiliated Hospital of University of South China,Hengyang,Hunan 421001,China)

机构地区：[1]南华大学附属第二医院医学影像科,湖南衡阳421001

出　　处：《现代医药卫生》2021年第8期1283-1287,共5页Journal of Modern Medicine & Health

基　　金：南华大学研究生科研创新项目(2016XCX45)。

摘　　要：目的探讨扩散加权成像(DWI)、体素内不相干运动扩散加权成像(IVIM-DWI)相关参数在前列腺不同组织中的差异,评估各参数鉴别诊断前列腺良、恶性病变的效能,探讨IVIM-DWI各参数对前列腺癌恶性程度的预测价值。方法收集2016年1月至2017年1月该院收治的62例就诊原因均为尿急、尿不尽、尿频或血尿患者的临床资料,另收集16例健康志愿者的相关资料,均行磁共振成像检查;在磁共振成像检查后1个月内获得病理检查结果。62例患者中前列腺癌27例,前列腺增生35例。对比分析不同前列腺组织表观扩散系数(ADC)、真实扩散系数(D)、灌注分数(f)、灌注相关扩散系数(D*)等;采用受试者工作特征曲线的曲线下面积评估DWI与IVIM-DWI的诊断价值;采用Spearman秩相关检验评估前列腺癌患者Gleason评分与IVIM-DWI各参数的相关性。结果前列腺癌患者ADC、D、f值均明显低于正常前列腺外周带与中央腺体、前列腺增生患者,差异均有统计学意义(P<0.05)。D值鉴别前列腺良、恶性病变的受试者工作特征曲线的曲线下面积最大(0.954);D值与前列腺癌患者Gleason评分呈明显负相关(r=-0.741,P=0.001)。结论在鉴别诊断前列腺良、恶性方面ADC、f、D、D*值均具有一定作用,其中诊断效能相对最高者为D值,有助于评估前列腺癌恶性程度。Objective To explore the differences of DWI and IVIM-DWI related parameters in different prostate tissues,to evaluate the efficiency of each parameter in the differential diagnosis of benign and malignant prostate diseases,and to investigate the predictive value of IVIM-DWI parameters for the malignant degree of prostate cancer(PCa).Methods The data of 62 patients with the visiting reasons such asurgent urination,incomplete urination,frequent urination or hematuria in this hospital from January 2016 to January 2017 were collected.The related data of 16 healthy volunteers were collected.The MRI examination was performed in all subjects;the pathological examination results obtained within 1 month after MRI examination.Among 62 cases,27 cases were PCa and 35 cases were prostatic hyperplasia.The apparent diffusion coefficient(ADC),true diffusion coefficient(D),perfusion fraction(f)and perfusion-related diffusion coefficient(D*)were compared between different prostatic tissues;the area under the receiver operating characteristic(ROC)curve was adopted to evaluate the diagnostic values of DWI and IVIM-DWI;the Spearman rank correlation test was used to evaluate the correlation between the Gleason score of PCa and the parameters of IVIM-DWI.Results The values of ADC,D and f value in the patients with PCa were lower than those in the prostatic peripheral zone,central gland and the patients with prostatic hyperplasia,and the differences were statistically significant(P<0.05).AUC of D value for identifying benign and malignant prostate lesions was maximal(0.954);the D value showed the significantly negative correlation with the Gleason score(r=-0.741,P=0.001).Conclusion In the differential diagnosis of benign and malignant prostate,the values of ADC,f,D and D*all play a certain role,and the D value is the relatively highest diagnostic efficiency and helps to evaluate the malignant degree of PCa.

关 键 词：前列腺癌 前列腺增生 磁共振成像 单指数模型 体素内不相干运动扩散加权成像 诊断效能 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学]