多模态磁共振对前列腺癌不同发病部位的研究  

Correlation Study of Multimodal Magnetic Resonance in Different Sites of Prostate Cancer

作　　者：崔丽华[1] 彭晓刚[1] 刘舰[1] 赵雪峰[1] Cui Lihua;Peng Xiaogang;Liu Jian;Zhao Xuefeng(Department of Imaging,The First Hospital of Qiqihar,Qiqihar,Heilongjiang 161000)

机构地区：[1]齐齐哈尔市第一医院影像科,黑龙江齐齐哈尔161000

出　　处：《现代医用影像学》2024年第10期1873-1878,共6页Modern Medical Imageology

摘　　要：目的:探讨多模态磁共振成像技术对诊断不同部位前列腺癌的相关性研究。方法:回顾性收集临床拟诊断为前列腺癌的患者162例,根据磁共振扫描不同序列分成两组:A组bpMRI(T2WI+DWI+ADC)82例;B组mpMRI(T2WI+DWI+ADC+DCE-MRI)80例;根据肿瘤发生位置不同分为两组:1组肿瘤位于外围带;2组肿瘤位于移行带、中央叶(中央腺体),所有患者均经临床穿刺活检取病理检测。利用诊断的试验评价指标和受试者工作特征曲线(Receiver operating characteristic,ROC),评估A/B两组对发生于不同部位前列腺癌诊断的相关性。结果:经直肠超声引导下会阴穿刺的162例患者中,良性89例,恶性73例,病变位于外围带67例,中央腺体95例;比较两组前列腺癌患者的变量情况,年龄(P=0.434)、ADC(P=0.233)和PSA(P=0.573)均在两组间分布差异无统计学意义;前列腺癌发病部位比较:在外围带:A方法和B方法诊断的准确性差异无统计学意义(P=0.97);在中央腺体:A方法诊断前列腺癌的准确性明显低于B方法,差异具有统计学意义(P<0.05);A组的ROC曲线下面积为0.630(0.508~0.752),灵敏度为68.2%,特异度为57.9%,阳性预测值为65.2%,阴性预测值为61.1%;B组的ROC曲线下面积为0.816(0.715~0.917),灵敏度为90.9%,特异度为72.2%,阳性预测值为80.0%,阴性预测值为86.7%,B组影像技术对发生于中央腺体的前列腺癌的诊断较A组有较好的诊断价值。结论:磁共振多参数扫描对发生于外围叶的前列腺癌检出无明显差异;而对发生于中央腺体的前列腺癌mpMRI较bpMRI更有利肿瘤的检出。Objective:To investigate the correlation of multimodal magnetic resonance imaging(bpMRI,mpMRI)to the diagnosis of prostate cancer in different sites.Materials and Methods:162 patients with clinically diagnosed prostate cancer were retrospectively collected and analyzed,and divided into 2 groups according to different sequences of magnetic resonance scanning:group A bpMRI(T2WI+DWI+ADC)82 cases;Group B mpMRI(T2WI+DWI+ADC+DCE-MRI)80 cases;They were divided into two groups according to different tumor locations:the first group was located in the peripheral zone;The tumors in the 2 groups were located in the central gland(transitional zone and central lobe),and all patients underwent clinical puncture bilpsy for pathological detection.The correlation between group A and group B in the diagnosis of prostate cancer at different sites was evaluated using diagnostic test evaluation indexes and Receiver operating characteristic(ROC).Results:Among 162 patients with perineal puncture guided by rectal ultrasound,89 cases were benign,73 cases were malignant,67 cases were peripheral lesions,95 cases were central glands,The variables of prostate cancer patients in the two groups were compared.Age(P=0.434),ADC(P=0.233)and PSA(P=0.573)were all distributed between the two groups,and the difference was not statistically significant.Comparison of the incidence sites of prostate cancer:In the peripheral zone:the accuracy of diagnosis between method A and method B was P=0.97,and the difference was not statistically significant.In the central gland,the accuracy of method A in the diagnosis of prostate cancer was significantly lower than that of method B,P<0.05,the difference was statistically significant.In group A,the area under R0C curve was 0.630(0.508~0.752),the sensitivity was 68.2%,the speciticity was 57.9%,the positive predictive value was 65.2%,and the negative predictive value was 61.1%.The area under ROC curve of group B was 0.816(0.715~0.917),the sensitivity was 90.9%,the speciticity was 72.2%,the positive predictive value wa

关 键 词：多模态磁共振 前列腺癌 穿刺活检 外围带 中央腺体 

分 类 号：R73[医药卫生—肿瘤]