合成MRI联合小视野体素内不相干运动成像对移行区前列腺癌的诊断价值  

The diagnostic value of synthetic MRI combined with reduced field of view intravoxel incoherent motion imaging in transition zone prostate cancer

作　　者：周柒柒 汤倩 陈文[1] 桑玲[1] 刘薇音 徐霖[1] ZHOU Qiqi;TANG Qian;CHEN Wen;SANG Ling;LIU Weiyin;XU Lin(Medical Imaging Center,Taihe Hospital,Hubei University of Medicine,Shiyan,Hubei Province 442000,China;Biomedical Engineering College,Hubei University of Medicine,Shiyan,Hubei Province 442000,China;China Magnetic Resonance Research Division,GE Healthcare,Beijing 100176,China)

机构地区：[1]湖北医药学院附属太和医院医学影像中心,湖北十堰442000 [2]湖北医药学院生物医学工程学院,湖北十堰442000 [3]GE医疗中国磁共振科研部,北京100176

出　　处：《实用放射学杂志》2023年第6期954-958,共5页Journal of Practical Radiology

基　　金：十堰市科技局项目(21Y39)。

摘　　要：目的探讨合成MRI中的弛豫时间联合小视野体素内不相干运动(IVIM)成像鉴别移行区前列腺癌(PCa)与良性前列腺增生(BPH)的价值。方法选取20例经活检证实的移行区PCa患者和28例BPH患者,所有患者均行合成MRI及小视野IVIM序列检查,将合成MRI及IVIM图像导入后处理软件进行处理,记录合成MRI的T_(1)值、T_(2)值、质子密度(PD)值及IVIM序列慢扩散系数(D)值、快扩散系数(D*)值和灌注分数(f)值,采用独立样本t检验比较各参数在PCa与BPH的统计学差异,应用受试者工作特征(ROC)曲线判别有统计学差异的各参数检验效能。结果PCa患者的T_(1)值[(1031.65±105.47)ms]和T_(2)值[(100.03±11.77)ms]均明显低于BPH患者[T_(1)值(1123.85±167.01)ms,T_(2)值(117.87±21.33)ms](P<0.05);PCa患者的D值[(0.55±0.05)×10^(-3) mm^(2)/s]、f值[(34.71±5.37)%]低于BPH患者[D值(0.73±0.07)×10^(-3) mm^(2)/s、f值(39.06±5.41)%],差异有统计学意义。鉴别PCa和BPH,合成MRI中T_(2)值曲线下面积(AUC)最大(0.770)、IVIM成像中D值AUC最大(0.998),D值、f值与合成MRI参数联合诊断效能均提高,其中D值与T_(1)值、T_(2)值联合诊断AUC均为1。结论合成MRI中的T_(2)值和IVIM成像中D值诊断敏感性和特异性较高,两者联合诊断效能更高,有助于移行区BPH及PCa的鉴别诊断。Objective To investigate the value of relaxation time in synthetic MRI combined with reduced field of view intravoxel incoherent motion(IVIM)imaging in differentiating transition zone prostate cancer(PCa)from benign prostatic hyperplasia(BPH).Methods A total of 20 patients with PCa in transition zone and 28 patients with BPH confirmed by biopsy were selected.All patients underwent synthetic MRI and reduced field of view IVIM sequence examination,and the synthetic MRI and IVIM images were imported into post-processing software for processing.T_(1),T_(2),proton density(PD)values of synthetic MRI,D,D^(*)and f values of IVIM sequence were recorded.The independent sample t test was used to compare the statistical differences of each parameter between PCa and BPH,and the receiver operating characteristic(ROC)curve was used to determine the test efficiency of each parameter with statistical differences.Results The T_(1) values[(1031.65±105.47)ms]and T_(2) values[(100.03±11.77)ms]in patients with PCa were significantly lower than those in patients with BPH[T_(1) value(1123.85±167.01)ms,T_(2) value(117.87±21.33)ms](P<0.05).The D value[(0.55±0.05)×10^(-3) mm^(2)/s]and f value[(34.71±5.37)%]in patients with PCa were lower than those in patients with BPH[D value(0.73±0.07)×10^(-3) mm^(2)/s and f value(39.06±5.41)%],and the difference was statistically significant.PCa and BPH were differentiated,and the area under the curve(AUC)T_(2) value was the largest in the synthetic MRI(0.770),while the AUC D value was the largest in the IVIM imaging(0.998).The combined diagnosis efficiency of D value,f value and synthetic MRI parameters was improved,and the AUC of the combined diagnosis of D value,T_(1) value and T_(2) value was 1.Conclusion The T_(2) value in synthetic MRI and D value in IVIM imaging have higher diagnostic sensitivity and specificity.The combination of synthetic MRI and IVIM model can improve the diagnostic efficiency and contribute to the differential diagnosis of BPH and PCa.

关 键 词：合成磁共振成像 前列腺癌 良性前列腺增生 弛豫时间 

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] R697.3[医药卫生—临床医学]