动态增强磁共振成像定量参数联合表观扩散系数值对外周带前列腺癌的诊断价值研究  

Study on the Diagnostic Value of Quantitative Parameters of Dynamic Enhanced Magnetic Resonance Imaging Combined with Apparent Diffusion Coefficient Values for Peripheral Prostate Cancer

作　　者：刘婷婷[1] 王晓辉[1] 王洪兴[1] 潘锋[1] 李昊 胡海峰[2] LIU Tingting;WANG Xiaohui;WANG Hongxing;PAN Feng;LI Hao;HU Haifeng(Imaging Center,Beijing Aerospace General Hospital,Beijing 100076,China;Department of Imaging,the Second Affiliated Hospital of Qiqihar Medical University,Qiqihar,Heilongjiang 161006,China)

机构地区：[1]北京航天总医院影像中心,北京100076 [2]齐齐哈尔医学院附属第二医院影像科,黑龙江齐齐哈尔161006

出　　处：《临床误诊误治》2024年第13期71-76,共6页Clinical Misdiagnosis & Mistherapy

基　　金：2020年度黑龙江省省属高等学校基本科研业务费科研项目(2020-KYYWF-0031)。

摘　　要：目的探究动态增强磁共振成像(DCE-MRI)定量参数联合表观扩散系数(ADC)值诊断外周带早期前列腺癌的价值。方法选取2019年2月至2021年12月经穿刺病理学检查确诊为外周带早期前列腺癌31例和前列腺炎27例为研究对象。患者均进行DCE-MRI定量参数检查,以病理学检查结果为金标准,分析不同患者的DCE-MRI特征。并采用受试者工作特征曲线下面积(AUC)分析基于DCE-MRI定量参数与扩散加权成像(DWI)序列对外周带早期前列腺癌与前列腺炎的诊断价值。结果31例前列腺癌患者中,T2加权成像(T2WI)以外周带结节状低信号为主,占58.06%;DWI以结节状、弥漫性高信号,ADC值下降为主,占51.61%;DCE-MRI可见病灶早期强化,以延迟后病灶造影剂退出,强化曲线呈流出型为主,占64.52%。27例前列腺炎患者中,T2WI以外周带单侧或双侧弥漫性不均匀低信号为主,占51.85%;DWI可见外周带单侧或双侧不规则高信号,ADC值降低为主,占59.26%;DCE-MRI可见病灶早期强化,以延迟后造影剂退出不明显,强化曲线呈流入型为主,占81.48%。外周带早期前列腺癌患者ADC值低于前列腺炎,速率常数(Kep)值、转移常数(K^(trans))高于前列腺炎(P<0.05)。DCE-MRI定量参数联合ADC值诊断外周带早期前列腺癌的AUC为0.862(95%CI:0.659,0.865)、敏感度为87.10%,特异度为81.48%,准确度为84.48%,阳性预测值为84.38%,阴性预测值为84.62%。结论DCE-MRI定量参数联合ADC值对外周带早期前列腺癌的诊断效能良好,能显著提高临床检出率,为疾病的诊断与治疗提供依据。Objective To explore the value of combined quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with apparent diffusion coefficient(ADC)values in the diagnosis of early peripheral prostate cancer.Methods In total,31 patients with early peripheral prostate cancer diagnosed by biopsy pathology from February 2019 to December 2021 and 27 patients with prostatitis were selected.All patients underwent DCE-MRI examination for quantitative parameters,and the pathological examination results were used as the gold standard to analyze the DCE-MRI characteristics of different patients.The area under receiver operating characteristic(ROC)curve(AUC)was used to analyze the diagnostic value of quantitative parameters of DCE-MRI and diffusion weighted imaging(DWI)sequences for early peripheral prostate cancer and prostatitis.Results In 31 patients with prostate cancer,T2-weighted imaging(T2WI)mainly showed nodular low signal in peripheral zone,accounting for 58.06%.DWI was characterized by nodular and diffuse high signal,and ADC value decreased,accounting for 51.61%.DCE-MRI showed early enhancement of the lesion,with the withdrawal of contrast agent after delay,and the enhancement curve was mainly outflow type,accounting for 64.52%.In 27 patients with prostatitis,unilateral or bilateral diffuse low signal in peripheral zone was the main feature on T2WI,accounting for 51.85%.In DWI,the irregular high signal of peripheral band was found on one or both sides,and ADC value decreased mainly,accounting for 59.26%.DCE-MRI showed early enhancement of the lesion,and the contrast agent withdrawal was not obvious after delay,and the enhancement curve was mainly inflow type,accounting for 81.48%.The ADC value of early peripheral prostate cancer was lower than that of prostatitis,and the rate constant(Kep)and metastasis constant(K^(trans))were higher than those of prostatitis(P<0.05).The AUC of quantitative parameters of DCE-MRI combined with ADC value in the diagnosis of early peripheral prostate c

关 键 词：前列腺肿瘤 前列腺炎 动态增强磁共振成像 扩散加权成像 病理学 诊断 受试者工作特征曲线 曲线下面积 

分 类 号：R737.25[医药卫生—肿瘤]