多参数磁共振成像对前列腺癌Gleason分级的诊断价值  

Diagnostic value of multiparametric MRI for Gleason grading of prostate cancer

作　　者：黄伟强 陈思 马欣越 周映辉[2] 李超 肖志辉 HUANG Weiqiang;CHEN Si;MAXinyue;ZHOU Yinghui;LI Chao;XIAO Zhihui(Department of Ultrasound,Pingxiang Second People’s Hospital,Pingxiang 337000,Jiangxi,China;Department of Ultrasound,the Second Xiangya Hospital of Central South University,Changsha 410011,Hu’nan,China;Department of Urology,Pingxiang Second People’s Hospital,Pingxiang 337000,Jiangxi,China;MRI Room,Pingxiang Second People’s Hospital,Pingxiang 337000,Jiangxi,China)

机构地区：[1]萍乡市第二人民医院超声科 [2]中南大学湘雅二医院超声科,长沙4100110 [3]萍乡市第二人民医院泌尿外科,江西萍乡337000 [4]萍乡市第二人民医院核磁共振室,江西萍乡337000

出　　处：《癌症进展》2024年第9期1008-1010,1024,共4页Oncology Progress

基　　金：江西省卫生健康委科技计划项目(202311743)。

摘　　要：目的目的探讨多参数磁共振成像(mpMRI)对前列腺癌Gleason分级的诊断价值。方法方法126例前列腺癌患者均行常规MRI检查、动态增强MRI检查、弥散加权成像(DWI)检查,比较不同Gleason分级前列腺癌患者的影像学参数;采用Spearman法分析DWI表观扩散系数(ADC)值与前列腺癌Gleason分级的相关性;根据Gleason分级结果将1~2级前列腺癌患者作为低级别前列腺癌组,3~5级前列腺癌患者作为高级别前列腺癌组,并采用受试者工作特征(ROC)曲线和曲线下面积(AUC)分析DWI ADC值对高级别前列腺癌的诊断价值。结果结果不同Gleason分级前列腺癌患者的DWI ADC值比较,差异均有统计学意义(P﹤0.05)。DWI ADC值与前列腺癌Glea-son分级呈负相关(P﹤0.05)。DWI ADC值诊断高级别前列腺癌的AUC为0.813(95%CI:0.740~0.886),灵敏度和特异度均为0.754,截断值为0.792×10-3 mm2/s。结论结论mpMRI对于诊断前列腺癌Gleason分级具有重要的参考价值,并且当DWI ADC值为0.792×10-3 mm2/s时,其诊断高级别前列腺癌的特异度和灵敏度均较高。Objective To explore the diagnostic value of multiparametric MRI(mpMRI)for Gleason grading of pros-tate cancer.Method A total of 126 patients with prostate cancer received routine MRI,dynamic enhanced MRI and dif-fusion weighted imaging(DWI)examination.The imaging parameters of prostate cancer patients with different Gleason grades were compared.The correlation between DWI apparent diffusion coefficient(ADC)value and Gleason grading of prostate cancer were analyzed by Spearman method.The prostate cancer patients were divided into low grade prostate cancer group(grade 1 to 2)and high grade prostate cancer group(grade 3 to 5)according to the Gleason grading results.The diagnostic value of DWI ADC value for high grade prostate cancer were analyzed by receiver operating characteris-tic(ROC)curve and area under the curve(AUC).Result There were significant differences in DWI ADC values in pros-tate cancer patients with different Gleason grades(P<0.05).The DWI ADC value was negatively correlated with Gleason grading of prostate cancer(P<0.05).The AUC of DWI ADC value in diagnosing high grade prostate cancer was 0.813(95%CI:0.740-0.886),the sensitivity and specificity were both 0.754,and cut-off value was 0.792×10-3 mm2/s.ConcluConclu-sion mpMRI has an important reference value in the diagnosis of Gleason grading of prostate cancer,and when the DWI ADC value is 0.792×10-3 mm2/s,its specificity and sensitivity in the diagnosis of high grade prostate cancer are high.

关 键 词：多参数磁共振成像 前列腺癌 GLEASON分级 诊断价值 

分 类 号：R737.25[医药卫生—肿瘤]