DCE-MRI和ADC值对前列腺良恶性病变的鉴别及ADC值与血清TPSA的关系  

DCE-MRI and ADC value to distinguish benign and malignant prostate lesions and the relationship between ADC value and serum TPSA

作　　者：李磊[1] 桂赞龙 程华根 王传圣[1] LI Lei;GUI Zanlong;CHENG Huagen;WANG Chuansheng(Department of Urology,Lu'an Hospital of Traditional Chitiese Medicine,Lu'an Anhui Province 237006,China)

机构地区：[1]六安市中医院泌尿外科,安徽六安237006

出　　处：《实用放射学杂志》2022年第4期612-615,共4页Journal of Practical Radiology

摘　　要：目的分析动态对比增强磁共振成像(DCE-MRI)联合扩散加权成像(DWI)在鉴别前列腺病变严重程度中的应用价值,并分析表观扩散系数(ADC)值与血清总前列腺特异抗原(TPSA)的关系.方法将96例前列腺病变患者依照病理诊断结果分为前列腺癌组和其他疾病组,行体检的50例健康者作为对照组;对患者行DCE-MRI和DWI扫描检查,记录患者转运常数(K^(trans))、血管外细胞外间隙容积百分数(V_(e))、速率常数(K_(ep))及ADC值;检测受试者血中TPSA水平;绘制受试者工作特征(ROC)曲线分析各指标鉴别诊断前列腺良恶性病变的价值,采用线性回归模型分析ADC值与血清TPSA的关系.结果对照组、其他疾病组及前列腺癌组患者K^(trans)、V_(e)、K_(ep)、DWI扫描信号强度、ADC值水平有明显差异,其中前列腺癌组患者K^(trans)、V_(e)及K_(ep)高于其他疾病组,DWI扫描信号强度及ADC值低于其他疾病组,且差异有统计学意义(P<0.05);采用DCE-MRI参数及ADC值联合应用鉴别前列腺良恶性病变的敏感度、特异度及曲线下面积(AUC)值均明显高于各指标单独应用,且差异有统计学意义(P<0.05);3组受试者血中TPSA水平有明显差异,其中前列腺癌组患者TPSA水平最高,对照组最低,且差异有统计学意义(P<0.05);前列腺癌患者ADC值与血清中TPSA水平呈显著负相关,且差异有统计学意义(P<0.05).结论DCE-MRI联合ADC值对前列腺良恶性病变进行鉴别诊断的敏感度、特异度及AUC鉴别诊断价值显著高于各指标单独应用,ADC值与血清TPSA水平呈显著负相关.Objective To analyze the application value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with diffusion weighted imaging(DWI)in differentiating the severity of prostate lesions,and to explore the relationship between apparent diffusion coefficient(ADC)value and serum total prostate specific antigen(TPSA).Methods 96 patients of prostate lesions were divided into prostate cancer group and other disease group according to the pathological diagnosis results.50 healthy people who underwent physical examination were taken as the control group.DCE-MRI and DWI scanning were performed on patients.The K^(trans),V_(e),K_(cp) and ADC values were recorded.And the TPSA level was detected.The receiver operating characteristic(ROC)curve was drawn to analyze the value of each index in differential diagnosis of benign and malignant prostate lesions.The relationship between ADC value and serum TPSA was analyzed by linear regression model.Results There were significant differences in K^(trans),V_(c),K_(ep),DWI scanning signal intensity and ADC value among control group,other disease group and prostate cancer group.The K,rans,Ve and Kep in prostate cancer group was higher than that in other disease group,while DWI scanning signal in tensity and ADC value was significantly lower than that in other disease group(P<0.05).The sensitivity,specificity and area under the curve(AUC)value of combined application of DCE-MRI parameters and ADC value in identity benign and malignant prostate lesions were significantly higher than those of single application of each index,and the difference was statistically significant(P<0.05).There were significant differences in TPSA levels among the three groups,with the highest TPSA level in prostate cancer group and the lowest in control group(P<0.05).The ADC value of prostate cancer patients was significantly negatively correlated with the serum TPSA level and the difference was statistically significant(P<0.05).Conclusion The sensitivity,specificity and AUC value of DCE-MRI comb

关 键 词：动态对比增强磁共振成像 表观扩散系数 前列腺良恶性病变 总前列腺特异抗原 

分 类 号：R445.2[医药卫生—影像医学与核医学] R697[医药卫生—诊断学] R737.25[医药卫生—临床医学]