3.0 T MR动态增强扫描定量分析诊断前列腺癌的初步研究

目的 探讨3.0 T MR动态增强扫描(DCE-MRI)定量分析诊断前列腺癌的可行性,并评价定量参数转运常数(Ktrans)、血管外细胞外间隙体积百分数(Ve)及速率常数(kep)与Gleason评分及前列腺特异性抗原(PSA)水平的相关性.方法 行前列腺DCE-MRI检查并经穿刺活检证实的38例患者,在Ktrans、Ve及kep参数图上取ROI测量前列腺相应部位的Ktrans、Ve及kep值.对前列腺癌区、外周带非癌区和中央腺体非癌区的参数值行方差分析,并采用Pearson相关分析检验各参数与Gleason评分、PSA水平的相关性.结果 前列腺癌区的Ktrans、Ve 、kep值分别为(0.35±0.26)/min、(0.185±0.080)、(1.42±0.53)/min,外周带非癌区则分别为(0.07±0.05)/min、(0.040±0.024)、(0.50±0.18)/min,中央腺体非癌区则分别为(0.19±0.06)/min、(0.161±0.062)、(0.94±0.25)/min,各参数值差异均有统计学意义(F值分别为16.267、44.084、36.095,P值均＜0.01),前列腺癌区的Ktrans、Ve及kep值均与Gleason评分、PSA水平无显著相关性(r值分别为0.279、0.069、0.109、-0.175、-0.067和0.137,P值均＞0.05).结论 DCE-MRI定量参数诊断前列腺癌具有可行性,有助于鉴别前列腺癌和良性前列腺病变.

Abstract：

Objectives To investigate the feasibility of the quantitative analysis parameters of dynamic contrast-enhanced MRI (DCE-MRI) in the diagnosis of prostate cancer and to correlate Ktrans, Ve and kep with histological grade (Gleason score) and serum prostate specific antigen (PSA). Methods MR examinations were performed in 38 patients confirmed by biopsy. ROI were drawn on areas of cancerous foci,noncancerous foci in the peripheral zone and central gland to measure the values of Krans, Ve and kep. The values of the three parameters in different tissue were compared with ANOVA. The correlations between the pharmacokinetic parameters and Gleason score, PSA were assessed with Pearson correlation. Results The Ktrans, Ve, kep values of cancerous foci were (0. 35 ± 0. 26 )/min, ( 0. 185 ± 0. 080 ), ( 1.42 ± 0. 53 )/min,respectively, while (0. 07 ± 0. 05 )/min, ( 0. 040 ± 0. 024 ), (0. 50 ± 0. 18 )/min for noncancerous foci in the peripheral zone and (0. 19 ±0. 06)/min, (0. 161 ± 0. 062), (0. 94 ±0. 25) /min for noncancerous foci in the central gland, respectively. The differences between the three parameters of cancerous foci,noncancerous foci in the peripheral zone and central gland were statistically significant ( F = 16. 267,44. 084, 36. 095, respectively; P ＜ 0. 01 ). No significant correlations were found between any parameter and either Gleason score or PSA (r =0. 279,0.069, 0. 109, -0. 175, -0.067,0. 137, respectively;P ＞0. 05). Conclusion Quantitative analysis parameters of DCE-MRI are feasible in diagnosing prostate cancer. They may be useful in differentiating prostate cancer from benign prostatic diseases.

A preliminary study of diagnosing prostate cancer with quantitative analysis of dynamic contrast-enhanced MR at 3. 0 T

Objectives To investigate the feasibility of the quantitative analysis parameters of dynamic contrast-enhanced MRI (DCE-MRI) in the diagnosis of prostate cancer and to correlate Ktrans, Ve and kep with histological grade (Gleason score) and serum prostate specific antigen (PSA). Methods MR examinations were performed in 38 patients confirmed by biopsy. ROI were drawn on areas of cancerous foci,noncancerous foci in the peripheral zone and central gland to measure the values of Krans, Ve and kep. The values of the three parameters in different tissue were compared with ANOVA. The correlations between the pharmacokinetic parameters and Gleason score, PSA were assessed with Pearson correlation. Results The Ktrans, Ve, kep values of cancerous foci were (0. 35 ± 0. 26 )/min, ( 0. 185 ± 0. 080 ), ( 1.42 ± 0. 53 )/min,respectively, while (0. 07 ± 0. 05 )/min, ( 0. 040 ± 0. 024 ), (0. 50 ± 0. 18 )/min for noncancerous foci in the peripheral zone and (0. 19 ±0. 06)/min, (0. 161 ± 0. 062), (0. 94 ±0. 25) /min for noncancerous foci in the central gland, respectively. The differences between the three parameters of cancerous foci,noncancerous foci in the peripheral zone and central gland were statistically significant ( F = 16. 267,44. 084, 36. 095, respectively; P ＜ 0. 01 ). No significant correlations were found between any parameter and either Gleason score or PSA (r =0. 279,0.069, 0. 109, -0. 175, -0.067,0. 137, respectively;P ＞0. 05). Conclusion Quantitative analysis parameters of DCE-MRI are feasible in diagnosing prostate cancer. They may be useful in differentiating prostate cancer from benign prostatic diseases.