3.0T MR 扩散加权成像对前列腺癌的诊断价值

目的研究3.0T磁共振系统扩散加权成像所得ADC值对前列腺癌的诊断价值。方法54例病理证实的前列腺病例,其外周带病理正常者18例(第一组),炎症13例(第二组),癌23例(第三组),每一例外周带以六分区法分为六区,并根据穿刺活检结果将各个外周带区域归类为正常组、炎症组及癌组。测量各分区的ADC值(b值=800s/mm2),对三个不同病理组进行方差分析。癌与非癌组之间进行ROC分析。结果正常组、炎症组、癌组ADC值依次降低,分别为(1.55±0.25)×10-3mm2/s、(1.40±0.23)×10-3mm2/s和(1.07±0.30)×10-3mm2/s,组间差异有统计学意义。ROC曲线上临界点取1.17×10-3mm2/s时,癌和非癌鉴别诊断的敏感性为61.3%,特异性为84.5%,准确性为80.0%。结论3.0T扩散加权成像可见前列腺外周带癌区、炎症区及正常区ADC值存在明显差异,可用于鉴别病变的性质。

Diagnostic value of 3.0T MR diffusion-weighted imaging in prostate cancer

Objective To study the diagnostic value of 3.0T DWI in prostate cancer. Methods Fifty-four cases of patients were verified by pathology after ultrasound guided systemic biopsy, with the results of 18 without lesion, 13 with prostatitis and 23 with cancer. The peripheral zone of prostate was divided into six parts by orientations and they were divided into non-cancerous, prostatitis and cancerous groups according to the results of biopsy. The ADC values of each peripheral zone were recorded and analyzed with one-way ANOVA and ROC analysis. Results The mean ADC of non-cancerous, prostatitis and cancerous groups were (1.55±0.25)×10^-3 mm²/sec, (1.40±0.23)×10^-3 mm²/sec and (1.07±0.30)×10^-3 mm²/sec respectively. The inter-group differences were statistically significant. With ROC cut point setting to 1.17×10^-3 mm²/s, the diagnostic sensitivity, specificity and accuracy for prostate cancer was 61.3%, 84.5% and 80.0% respectively. Conclusion The ADC values of peripheral zone of prostate were significantly different in non-cancerous, prostatitis and cancerous regions. So 3.0T DWI may help to differentiate the prostate lesions.