超高b值弥散加权成像、非高斯弥散模型鉴别移行带前列腺癌和基质型增生结节的价值  

Diagnostic Value of Ultra-high b Value Diffusion-weighted Imaging,Non-Gaussian Models in the Quantitative Differentiation of Transition Zone Prostate Cancer from Stromal Hyperplasia Nodules

作　　者：钟燕[1] 马露 申艳光 王鑫坤[1] 李天然[1] 叶慧义[4] ZHONG Yan;MA Lu;SHEN Yanguang;WANG Xinkun;LI Tianran;YE Huiyi(Department of Radiology,The Fourth Medical Center of Chinese PLA General Hospital,Beijing 100142,China;Department of Radiology,Tsinghua University Hospital;Department of Medical Imaging,Third Affliated Hospital of Beijing University of Chinese Medicine;Department of Radiology,The First Medical Center of Chinese PLA General Hospital)

机构地区：[1]解放军总医院第四医学中心放射诊断科,北京100142 [2]清华大学医院放射科 [3]北京中医药大学第三附属医院医学影像科 [4]解放军总医院第一医学中心放射诊断科

出　　处：《中国医学计算机成像杂志》2023年第6期637-641,共5页Chinese Computed Medical Imaging

基　　金：国家自然科学基金面上项目(81771785)。

摘　　要：目的:探讨超高b值弥散加权成像(DWI)、体素内不相关运动(IVIM)模型和峰度模型鉴别移行带前列腺癌和基质型增生结节的价值。方法:回顾性分析经穿刺活检病理证实的14例移行带前列腺癌和有基质型增生结节的23例良性前列腺增生(BPH)患者。所有患者行超高b值DWI、IVIM和峰度模型检查。在后处理工作站勾画每个病灶的感兴趣区(ROI),测量病灶的表观弥散系数(ADC)、分子弥散系数(D)、灌注分数(f)、伪弥散系数(D*)、平均峰度(MK)和平均弥散系数(MD)。采用受试者工作特征(ROC)曲线分析各参数鉴别2种病变的诊断效能。采用Z检验比较曲线下面积(AUC)的差异。结果:移行带前列腺癌的ADC、MD、D和f值明显低于基质型增生结节(P<0.001,P<0.001,P<0.001和P=0.001),而移行带前列腺癌的MK值显著高于基质型增生结节(P<0.001);2种病变之间的D*值差异无统计学意义(P>0.05)。鉴别2种病变,ADC、MK+MD的AUC显著高于D值和f值(均P<0.05);MD值的AUC高于D值(P<0.05);余参数之间的AUC无统计学差异(P>0.05)。结论:超高b值DWI、IVIM和峰度模型都可以有效地鉴别移行带前列腺癌和基质型增生结节,参数ADC和MK+MD的诊断效能优于IVIM模型的参数。Purpose:To evaluate the diagnostic value of ultra-high b value diffusion-weighted imaging(DWI),intravoxel incoherent motion(IVIM)model and kurtosis model in differentiation between transition zone(TZ)prostate cancer and stromal hyperplasia nodules.Methods:Fourteen patients with TZ prostate cancer and 23 patients with stromal hyperplasia who were pathologically confirmed by prostate biopsy were retrospectively analyzed.All patients underwent preoperative ultra-high b-value DWI,IVIM and kurtosis models.The apparent diffusion coefficient(ADC),molecular diffusion coefficient(D),perfusion fraction(f),pseudo-diffusion coefficient(D'),mean kurtosis(MK)and mean diffusivity(MD)values were calculated and compared between the two groups.Receiver operating characteristic(ROC)curve analysis and areas under the ROC curve(AUC)were carried out for all parameters.Results:Compared to stromal hyperplasia nodules,the ADC,MD,D and f values of TZ prostate cancer were significantly reduced(P<0.001,P<0.001,P<0.001,and P=0.001,respectively),while the MK value was significantly increased(P<0.001).There was no statistical difference in D'(P>0.05)between TZ prostate cancer and stromal hyperplasia nodules.The AUC of ADC and MK+MD showed significantly higher value than D and f(P<0.05).The AUC of MD was significantly higher than D(P<0.05).The AUC of other parameters was with no statistical difference(P>0.05).Conclusion:The ultra-high b-value DWI with IVIM,and kurtosis models are all useful for the differentiation of prostate cancer from stromal hyperplasia nodule in the transition zone,and the ADC and MK+MD parameters are with better performance than IVIM-derived parameters.

关 键 词：弥散 体素内不相干运动 峰度 良性前列腺增生 前列腺癌 

分 类 号：R445.2[医药卫生—影像医学与核医学]