DWI和DCEMRI对外周带不同类型T2WI低信号慢性前列腺炎的诊断价值  

DWI and DCE-MRI in Diagnosis of Different Types of Chronic Prostatitis with Peripheral T2WI Low-Signal

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

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

出　　处：《中国医学计算机成像杂志》2021年第5期425-430,共6页Chinese Computed Medical Imaging

基　　金：宁夏回族自治区重点研发项目(2019BEG03033);宁夏医科大学科学研究资助重点项目(NZ2017008)。

摘　　要：目的:探讨3.0T弥散加权成像(DWI)和动态对比增强磁共振成像(DCE-MRI)对外周带不同类型T2加权成像(T2WI)低信号慢性前列腺炎(CP)的诊断和鉴别诊断价值。方法:回顾性分析经病理证实且T2WI外周带均表现为低信号的65例CP患者的DWI和DCE-MRI资料,根据T2WI低信号病灶的形态和信号均匀度分为单侧或双侧外周带弥漫性低信号组(CP1)、局灶性低信号组(CP2)和弥漫性不均匀稍低信号组(CP3)。同时选择病理证实且T2WI表现为单侧或双侧外周带弥漫性低信号的22例前列腺癌(PCa1组)和18例局灶性低信号前列腺癌(PCa2组)患者的DWI和DCE-MRI资料作为对比。比较不同CP组和PCa组患者之间表观弥散系数(ADC)值和信号强度-时间(SI-T)曲线类型的差异,并绘制受试者操作特征(ROC)曲线确定ADC值诊断外周带CP的最佳临界点。结果:CP1组、CP2组和CP3组的ADC值分别为(1.05±0.07)×10–3mm2/s、(1.03±0.04)×10^(-3)mm^(2)/s和(1.26±0.10)×10^(-3)mm^(2)/s。CP组和PCa组平均ADC值分别为(1.19±0.13)×10^(-3)mm^(2)/s和(0.84±0.14)×10^(-3)mm^(2)/s,差异有统计学意义(t=14.27,P<0.01)。CP1组和PCa1组、CP2组和PCa2组ADC值差异均有统计学意义(t=10.68、3.35,均P<0.01)。根据ROC曲线分析,ADC值最佳临界点取1.03×10^(-3)mm^(2)/s,诊断外周带CP的灵敏度为84.80%,特异度为91.30%,准确度为89.32%。DCE-MRI CP1组,Ⅰ型曲线占8.00%,Ⅱ型占64.00%,Ⅲ型占28.00%;CP2组,Ⅰ型曲线占9.09%,Ⅱ型占72.73%,Ⅲ型占18.18%;CP3组,Ⅰ型曲线占63.77%,Ⅱ型占36.23%,Ⅲ型占0%。SI-T曲线类型在CP1和PCa1中的分布差异有统计学意义(P<0.05),在CP2和PCa2中的分布差异则无统计学意义(P>0.05)。结论:DWI ADC值可定量诊断外周带CP,并且有助于外周带不同类型T2WI低信号CP和PCa的鉴别。DCE-MRI SI-T曲线可以鉴别外周带T2WI弥漫性低信号CP和PCa,但对局灶性低信号CP和PCa无明显鉴别价值。Purpose:To evaluate the value of 3.0 T diffusion weighted imaging(DWI)and dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)in the diagnosis and differential diagnosis of different types of chronic prostatitis(CP)with peripheral low-signal in T2 weighted imaging(T2 WI).Methods:The date of 65 CP patients with hypointense T2 WI signal in peripheral zone was retrospectively analyzed.These patients had undergone T2 WI,DWI,and DCE-MRI examination,and they were all confirmed by pathological results.According to the morphology,uniformity and intensity of T2 WI low signal,these patients were divided into unilateral or bilateral peripheral low diffuse signal group(CP1),focal low signal group(CP2)and diffuse uneven low signal group(CP3).At the same time,the DWI and DCE-MRI data of 22 patients with prostate cancer(PCa1)showed diffuse low signal in peripheral zone of T2 WI and 18 patients with prostate cancer(PCa2)showed focal low signal of T2 WI confirmed by pathological results were also compared with those of CP patients.Apparent diffusion coefficient(ADC)value and signal intensity-time(SI-T)curve types of the two groups were obtained,and the difference between the two groups was compared.The receiver operator characteristic(ROC)cure was used to determine the cutoff value of ADC value for PCa detection.Results:The ADC value of CP1 group,CP2 group,and CP3 group was(1.05±0.07)×10^(-3)mm^(2)/s,(1.03±0.04)×10^(-3)mm^(2)/s and(1.26±0.10)×10^(-3)mm^(2)/s,respectively.The mean ADC value of CP group and PCa group was(1.19±0.13)×10^(-3)mm^(2)/s and(0.84±0.14)×10^(-3)mm^(2)/s,respectively(t=14.27,P<0.01).The difference between the CP1 group and PCa1 group,CP2 group and PCa2 group was with statistical significance(t=10.68,3.35,all P<0.01).According to the ROC analysis,when the cutoff value was set as 1.03×10^(-3)mm^(2)/s,the sensitivity,specificity and accuracy for diagnosis of PCa was 84.80%,91.30%and 89.32%,respectively.On DCE-MRI,the distribution of curve types for CP1 was typeⅠ8.00%,typeⅡ64.00%and type�

关 键 词：前列腺肿瘤 磁共振成像 动态增强 弥散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]