3.0T DCE-MRI与DWI对前列腺癌的诊断价值及与前列腺特异性抗原的相关性

目的探讨3.0T磁共振动态增强(DCE-MRI)及弥散加权成像(DWI)在前列腺癌(PCa)疾病诊断中的应用价值,以及各参数与前列腺特异性抗原(PSA)相关性分析。方法回顾性分析行前列腺MRI检查的患者62例,所有病例均以病理学诊断为金标准,研究对象均行MR常规、DCE-MRI及DWI检查。分析前列腺增生(BPH)及PCa的DCE-MRI信号变化、时间-信号强度曲线(TIC)特征及各参数相对值、表观扩散系数(ADC)值的变化情况,并利用SPSS软件进行各参数与PSA相关性分析。结果 BPH及PCa的平均达峰时间(Tmax)、最大增强斜率(MSI)及信号增强率(SER)分别为(82 903.45±26 594.31)ms vs(69 073.56±17 438.00)ms、(188.31±36.86)vs(215.69±59.66)、(109.14±13.78)vs(121.71±20.82),两者间比较差异有统计学意义(P<0.05);BPH的TIC多表现为Ⅰ型或Ⅱ型,PCa的TIC多表现Ⅲ型,两者间比较差异有统计学意义(P<0.05)。BPH与PCa平均ADC值及指数化表观扩散系数(EADC)值分别为(1.0±0.24)×10-3 mm2/s vs(0.7±0.22)×10-3 mm2/s、(0.36±0.09)×10-3 mm2/s vs(0.49±0.09)×10-3mm2/s,两者间比较差异有统计学意义(P<0.05)。DCE-MRI对PCa诊断的敏感性、特异性、准确性分别为63%、89%、74%,DWI对PCa诊断的敏感性、特异性、准确性分别为77.8%、82.9%、80.7%,两种检查方法相结合诊断PCa的敏感性、特异性、准确性分别为94%、85%、94%。PSA与ADC呈明显负相关。结论 DCE-MRI及DWI对PCa有很好的诊断价值,联合应用可明显提高PCa的诊断及鉴别诊断率。ADC值有助于对PCa的生物学特性进行初步评估。

The diagnostic value of 3.0T DCE-MR and DWI in prostate cancer and the correlation with PSA

Objective To evaluate the diagnostic value of 3.0T magnetic resonance dynamic contrast-enhanced imaging(DCE) and diffusion weighted imaging(DWI) in prostate cancer,and to analyse various parameters′ correlation with PSA.Methods A retrospective analysis was conducted in 62 patients after prostate MRI check,and all the cases were used surgical pathology findings as the gold standard.All participants did MR routine,dynamic enhanced and DWI check.BPH and PCa DCE MRI signal changes,time-signal intensity curve(TIC) and parameters,the relative value of apparent diffusion coefficient(ADC) value changes were analysed,and SPSS software was used to analyse the correlation with PSA.Results BPH and PCa in the mean time to peak(Tmax),maximum slope of increase(MSI) and signal enhancement ratio(SER) were respectively(82 903.45 ±26 594.31) ms vs(69 073.56 ±17 438) ms,(188.31±36.86) vs(215.69 ±59.66),(109.14 ±13.78) vs(121.71±20.82),which showed significant difference(P<0.05).BPH TIC curve manifested typeⅠor typeⅡ,while PCa curve type Ⅲ,which were significantly different(P<0.05).The average ADC value and index of apparent diffusion coefficient(EADC) value of BPH and PCa were respectively(1.0±0.24)×10-3 mm2/s vs(0.7±0.22)× 10-3 mm2/s,(0.36±0.09)× 10-3 mm2/s vs(0.49±0.09)× 10-3 mm2/s,which showed significant difference(P<0.05).The sensitivity,specificity,accuracy of DCE-MRI in diagnosing prostate cancer were 63%,89%,74%,sensitivity,specificity,accuracy of DWI were 77.8%,82.9%,80.7%,and the combination of the two methods showed 94%,85%,94%.PSA and ADC showed a significant negative correlation.Conclusion DCE-MRI and DWI have good diagnostic value for prostate cancer,the combination can significantly improve diagnosis and differential diagnosis of prostate cancer.The value of ADC contributes to the preliminary assessment of biological characteristics in prostate cancer.