磁共振弥散加权成像和动态对比增强多参数在前列腺癌诊断中的价值研究  

Diagnostic value of dynamic contrast-enhanced imaging with multiple parameters compared with T_(2)WI and DWI in prostate cancer

作　　者：潘金万[1] 李棠华 Pan Jinwan;Li Tanghua(Department of Radiology,the Second Hospital of Longyan City,Fujian 364000,China)

机构地区：[1]福建省龙岩市第二医院放射科,364000

出　　处：《实用医学影像杂志》2022年第3期225-228,共4页Journal of Practical Medical Imaging

摘　　要：目的探讨动态对比增强磁共振成像(DCE-MRI)的多参数相对于T_(2)加权成像(T_(2)WI)和弥散加权成像(DWI)双参数对前列腺癌的诊断价值。方法纳入本院2020年1月至2021年3月收治的疑似前列腺癌患者78例,入院后均行T_(2)WI、DWI、DCE-MRI检查,由2名放射科医师根据检查报告对所有图像进行分析,最终以病理结果为金标准,分别计算T_(2)WI、DWI、DCE-MRI单独与联合诊断前列腺癌的准确度、灵敏度及特异度。结果78例患者经病理检查诊断前列腺癌50例,其余28例为前列腺良性病变,2名影像诊断医师分析影像资料的一致性较高,Kappa值0.741。其中T_(2)WI诊断38例,高估8例;DWI诊断39例,高估7例;DCE-MRI诊断52例,高估10例;T_(2)WI+DWI诊断49例,高估5例;T_(2)WI+DWI+DCE-MRI诊断51例,高估3例;经比较不同MRI参数的诊断效能发现,T_(2)WI+DWI+DCE-MRI诊断前列腺癌的敏感度、特异度及准确度均处于最高水平,分别为96.0%、89.3%、93.6%,明显高于单独T_(2)WI、DWI、DCE-MRI,差异有统计学意义(P<0.05),但T_(2)WI+DWI+DCE诊断前列腺癌的准确度与T_(2)WI+DWI比较差异无统计学意义(P>0.05)。结论采用DCE-MRI多参数相对于T_(2)WI和DWI双参数对前列腺癌的诊断价值明显升高,但仍然建议将T_(2)WI、DWI、DCE-MRI三者联合将对前列腺癌术前分期提供重要诊断依据。Objective To investigate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in prostate cancer compared with T_(2)weighted imaging(T_(2)WI)and diffusion-weighted imaging(DWI).Methods Seventy-eight patients with suspected prostate cancer admitted to our hospital from January 2020 to March2021 were included.All patients underwent T_(2)WI,DWI and DCE-MRI after admission.Two radiologists analyzed all the images according to the examination report,and finally calculated the accuracy,sensitivity and specificity of T_(2)WI,DWI and DCE-MRI in the diagnosis of prostate cancer.Results Fifty cases with prostate cancer were diagnosed by pathological examination in 78 patients,and the remaining 28 cases were benign prostate lesions.The consistency of image data analyzed by two imaging diagnostic physicians was high,Kappa=0.741.Among them,38 cases were diagnosed by T_(2)WI,8 cases were overestimated,39 cases were diagnosed by DWI,7 cases were overestimated,52 cases were diagnosed by DCE-MRI,10 cases were overestimated,49 cases were diagnosed by T_(2)WI+DWI,5 cases were overestimated,51 cases were diagnosed by T_(2)WI+DWI+DCE-MRI,3 cases were overestimated;The sensitivity,specificity and accuracy of T_(2)WI+DWI+DCE-MRI in the diagnosis of prostate cancer were 96.0%,89.3%and 93.6%respectively,which were significantly higher than those of T_(2)WI,DWI and DCE-MRI alone(P<0.05),however,the accuracy rate of T_(2)WI+DWI+DCE in diagnosing prostate cancer was not significantly different from that of T_(2)WI+DWI(P>0.05).Conclusion The diagnostic value of DCE-MRI is significantly higher than that of T_(2)WI and DWI in the diagnosis of prostate cancer,but it is still suggested that the combination of T_(2)WI,DWI and DCE-MRI will provide an important basis for the preoperative staging of prostate cancer.

关 键 词：磁共振成像 图像增强 前列腺肿瘤 T_(2)加权成像 扩散加权成像 

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]