扩散加权成像对不同解剖区带起源前列腺癌的诊断效能评价  

Diagnostic efficacy of diffusion weighted imaging for prostate cancer in different zonal origins

作　　者：仲津漫 车志文 刘景哲 杨全新[1] ZHONG Jinman;CHE Zhiwen;LIU Jingzhe;YANG Quanxin(Department of Radiology,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China;Department of Radiology,Aksu City People’s Hospital,Aksu 843000,China)

机构地区：[1]西安交通大学第二附属医院医学影像科,陕西西安710004 [2]阿克苏市人民医院影像科,新疆阿克苏843000

出　　处：《实用放射学杂志》2025年第3期434-437,466,共5页Journal of Practical Radiology

基　　金：陕西省重点研发计划项目(2024SF-YBXM-417);西安交通大学第二附属医院科研基金项目(YJ(QN)202313)。

摘　　要：目的评估前列腺癌区带定位与扩散加权成像(DWI)诊断定位的一致性,探讨DWI对移行带和外周带前列腺癌的诊断效能.方法选取行根治术的局限性前列腺癌患者,采用李克特5分量表法在DWI序列对前列腺癌的可能性大小评分,分为≤2分的无可疑癌灶组(91例)和≥3分的可疑癌灶组(194例);t检验、Mann-Whitney U检验及χ^(2)检验比较2组临床病理特征的差异;多元回归分析检测可疑癌灶组的DWI评分与病理特征之间的相关性.根据肿瘤所在区带分为外周带组和移行带组,χ^(2)检验比较可疑癌灶组DWI影像定位与区带定位的一致性.结果285例前列腺癌患者中,可疑癌灶组前列腺特异性抗原(PSA)、Gleason评分、临床/病理分期、肿瘤体积及包膜外侵犯率均较无可疑癌灶组增高,组间有统计学差异(P<0.05);多元回归检验结果显示DWI评分与病理Gleason评分、病理分期、肿瘤体积、包膜外侵犯率均呈正相关(P<0.05).DWI对不同区带起源前列腺癌的诊断一致率随评分增高而增加,但对外周带组的诊断一致率高于移行带组,且在DWI评分>3分的高分组差异更显著(P<0.05).结论DWI评分更高的前列腺癌对应的恶性临床病理特征更显著,DWI影像-病理诊断的一致性更好.此外,DWI对外周带前列腺癌的诊断一致性高于移行带前列腺癌,且这种差异在DWI高分组更为明显.Objective To evaluate the diagnostic concordance rates between zonal localization and diffusion weighted imaging(DWI)localization of prostate cancer,and to investigate the diagnostic efficacy of DWI for prostate cancer in the transition zone and peripheral zone.Methods Patients with localized prostate cancer who underwent radical prostatectomy were selected.5-grade Likert-scale was used to determine the suspicion level of prostate cancer in DWI sequnence.Patients were divided into no suspicious lesion group(91 cases)(grade≤2 points)and suspicious lesion group(194 cases)(grade≥3 points).The t test,Mann-Whitney U test andχ^(2)test were used to compare the clinicopathological features between the two groups.Multiple regression analysis was used to detect the correlation between DWI grading and pathological features in the suspicious lesion group.Patients were also divided into transition zone and peripheral zone groups according to zonal localization of lesions.The diagnostic concordance rates between DWI image localization and zonal localization in the suspicious lesion group were compared byχ^(2)test.Results The study included 285 prostate cancer patients,the prostate-specific antigen(PSA),Gleason score,clinical/pathological stages,tumor volume and extracapsular extension of the suspicious lesion group were higher than those of the no suspicious lesion group with significant differences(P<0.05).Multiple regression test results showed significant positive correlations between DWI grading and pathological features,including pathological Gleason score,pathological stages,tumor volume and extracapsular extension(P<0.05).The diagnostic concordance rates of DWI for prostate cancer in different zonal origins increased with the increase of DWI grading.The diagnostic concordance rates of peripheral zone group were higher than those of transition zone group,with more significant differences showed in DWI grade>3 points(P<0.05).Conclusion Prostate cancer with higher DWI grading may have more aggressive clinicopathologi

关 键 词：多参数磁共振成像 扩散加权成像 前列腺癌 移行带 外周带 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学]