磁共振动态增强定量参数和ADC值对前列腺癌的临床诊断价值  

Diagnostic Value of Quantitative Analysis of ADC Value and DCE-MRI Parameters for Prostate Cancer

作　　者：朱光斌 罗锦文[1] 邓义[1] 关玉宝[1] 杜国新 刘志强 欧阳中敏[1] ZHU Guangbin;LUO Jinwen;DENG Yi;GUAN Yubao;DU Guoxin;LIU Zhiqiang;OUYANG Zhongmin(Department of Radiology,The Fifth Affiliated Hospital,Guangzhou Medical University)

机构地区：[1]广州医科大学附属第五医院医学影像科

出　　处：《中国医学计算机成像杂志》2021年第4期308-312,共5页Chinese Computed Medical Imaging

摘　　要：目的:探索磁共振表观弥散系数(ADC)联合动态对比增强磁共振成像(DCE-MRI)灌注参数对前列腺癌与非癌组织、前列腺增生的鉴别诊断价值。方法:纳入经病理证实的前列腺癌(n=45)、前列腺癌旁非癌组织(n=41)和良性前列腺增生(n=38)的磁共振影像资料,计算弥散加权成像(DWI)b=1000s/mm^(2)时的ADC值,获取DCE-MRI的灌注参数[包括容积转运常数(K^(trans))、组织间隙-血浆速率常数(Kep)和血管外细胞外间隙容积分数(Ve)],并进行多组间比较。利用受试者操作特征(ROC)曲线分析各参数对前列腺癌的诊断效能。结果:前列腺癌组DWI信号随b值升高,呈明显高信号,ADC值较良性前列腺增生组、非癌组均明显降低(P<0.05);前列腺癌组DCE-MRI定量参数中K^(trans)、Kep均明显高于良性前列腺增生组和非癌组,差异有统计学意义(P<0.05);3组间Ve比较,差异则无统计学意义(P>0.05)。ROC曲线分析显示,ADC、K^(trans)、Kep值及三者联合诊断前列腺癌的曲线下面积分别为0.805、0.703、0.695、0.906。结论:ADC值和磁共振灌注定量参数K^(trans)、Kep对前列腺癌具有较高的诊断效能,三者联合应用可以为鉴别诊断前列腺癌提供更加精确可靠的量化参数。Purpose:To investigate the value of quantitative parameters combined with apparent diffusion coefficient(ADC)and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the differential diagnosis of benign prostatic hyperplasia(BPH),non-cancerous tissues and prostate cancer(PCa).Methods:A total of83 patients with prostatic diseases confirmed by puncture pathology results were selected.Among them,45 cases were confirmed with PCa(from which,41 cases of adjacent non-cancerous prostate tissues were simultaneously collected),and 38 cases were with BPH.The volume transfer constant(K^(trans)),interstitium-to-plasma rate constant(Kep),extravascular extracellular space volume fraction(Ve)and ADC of these lesions were compared with one-way analysis of variance,the diagnostic efficiency of each parameter was analyzed by the receiver operating characteristic(ROC)curve.Results:DWI signal of PCa group increased with b value,and ADC value was significantly lower than that of BPH group and non-cancerous group(P<0.05),the K^(trans)and Kep of DCE-MRI quantitative parameters in PCa group were significantly higher than those in BPH group and non-cancerous group(P<0.05);There was no significant difference in Ve among these three groups(P>0.05);ROC curve analysis showed that the area under the curve of ADC,K^(trans),Kep and their combined diagnosis of PCa were 0.805,0.703,0.695 and 0.906,respectively.Conclusion:The ADC value and perfusion quantitative parameters K^(trans) and Kep have high diagnostic efficiency in the diagnosis of PCa,and the combination of them can provide more accurate and reliable quantitative parameters for the differential diagnosis of PCa.

关 键 词：前列腺癌 弥散加权成像 表观弥散系数 动态对比增强磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]