3.0T磁共振小视野IVIM-DWI联合血清fPSA/tPSA鉴别诊断前列腺癌的应用评价  

Application Evaluation of 3.0T Magnetic Resonance Small Field IVIM-DWI Combined with Serum fPSA/tPSA in Differential Diagnosis of Prostate Cancer

作　　者：王兴林 敬杰 李海青 郭志伟 Wang Xing-lin;Jing Jie;Li Hai-qing;Guo Zhi-wei(Radiology Department of Nanchong Central Hospital,Nanchong 637000,Sichuan Province,China)

机构地区：[1]南充市中心医院放射科,四川南充637000

出　　处：《中国CT和MRI杂志》2023年第10期142-145,共4页Chinese Journal of CT and MRI

基　　金：[基金课题]四川省医学科研青年创新课题计划(Q20043)。

摘　　要：目的 探讨3.0T磁共振小视野体素不相干运动扩散加权成像(IVIM-0WI)联合血清前列腺游离特异性抗原/总特异性抗原(fPSA/t PSA)鉴别诊断前列腺癌的应用价值。方法 选取2020年3月~2022年1月分别经手术病理证实的73例前列腺癌患者(癌症组)与73例前列腺增生患者(增生组),比较两组常规视野、小视野下纯扩散系数(D值)、灌注相关扩散系数(D*值)、灌注分数(f值)、图像质量视觉模拟评分法(VAS)评分、血清总前列腺特异抗原(tPSA)、游离前列腺特异抗原(fPSA)、fPS/tPSA,采用受试者工作特征曲线(ROC)分析D值、f值、fPSA、tPSA、f PSA/tPSA鉴别诊断前列腺癌的价值,采甩SPSS软件的联合应用ROC理论模式建立不同联合诊断方案的Logis tic方程,筛选出最佳鉴别诊断方案。结果 常规视野与小视野下,癌症组D值均低于增生组,f值均高于增生组(P<0.05);小视野下D值、f值、D*值与常规视野下D值、f值、D*值比较,差异均无统计学意义(P>0.05);小视野图像质量VAS评分高于常规视野(P>0.05);癌症组fPSA、 tPSA高于增生组,fPSA/tPSA低于增生组(P<0.05);各联合方案诊断前列腺癌的ROC下面积(AUC)大于单一指标,且D值+f值+fPSA/tPSA的AUC大于D值+fPSA/tPSA、f值+fPSA/tPSA(P<0.05),运用外部数据验证D值+f值+fPSA/tPSA的鉴别诊断价值显示,其诊断准确率为91.67%(55/60)。结论 前列腺癌与增生组织D值、f值、血清fPSA/tPSA差异明显,联合检测可作为前列腺癌的一种非侵入、无创、可靠的鉴别诊断方案;与常规视野相比,3.0T磁共振小视野IVIM-CWI能够更清晰地显示前列腺占位性病变的形态、边界等相关信息,为前列腺癌的诊断提供更多帮助。Objective To investigate the application value of 3.0T magnetic resonance small field voxel incoherent motion diffusion-weighted imaging(IVIM-DWI)combined with serum free specific antigen/total specific antigen(fPSA/tPSA)in the differential diagnosis of prostate cancer.Methods 73 patients with prostate cancer(cancer group)and 73 patients with benign prostatic hyperplasia(hyperplasia group)who were confirmed by surgery and pathology from March 2020 to January 2022 were selected,and the pure diffusion coefficient(D value),perfusionrelated diffusion coefficient(D*value),perfusion fraction(f value),image quality visual analogue scale(VAS)score,serum total prostate specific antigen(tPSA),free prostate specific antigen(fPSA),fPSA/tPSA,the receiver operating characteristic curve(ROC)was used to analyze the value of D value,f value,fPSA,tPSA,fPSA/tPSA in the differential diagnosis of prostate cancer,and the combined ROC theory model of SPSS software was used to establish the Logistic of different combined diagnosis schemes Equation to screen out the best differential diagnosis scheme.Results The D value of the cancer group was lower than that of the hyperplasia group,and the f value of the cancer group was higher than that of the hyperplasia group under the conventional field of view and the small field of view(P<0.05);Compared with the D value,f value and D*value in the small field of view and the D value,f value and D*value in the conventional field of view,there was no significant difference(P>0.05);The VAS score of the image quality in the small field of view was higher than that in the conventional field of view(P<0.05);the fPSA and tPSA in the cancer group were higher than those in the hyperplasia group,and the fPSA/tPSA ratio was lower than that in the hyperplasia group(P<0.05);The area under ROC(AUC)for the diagnosis of prostate cancer in each combination scheme was greater than that of a single index,and the AUC of D value+f value+fPSA/tPSA was greater than D value+fPSA/tPSA,f value+fPSA/tPSA(P<0.05).The differe

关 键 词：3.0T磁共振 小视野 IVIM-DWI 常规视野 血清fPSA/tPSA 前列腺癌 

分 类 号：R445.2[医药卫生—影像医学与核医学]