IVIM-DWI联合动态增强MRI对前列腺癌诊断及分级的评估价值

目的探究IVIM-DWI联合动态增强MRI对前列腺癌诊断及分级的评估价值。方法选取2017年3月至2018年4月我院泌尿外科收治的42例前列腺癌患者作为研究对象,同期38例良性前列腺增生患者作为对照组。两组患者均进行IVIM-DWI、DCE-MRI检查,经图像后处理得IVIM-DWI参数真实扩散系数(D)、伪扩散系数(D*)、灌注分数(f);DCE-MRI参数容量转移常数、速率常数、血管外细胞外间隙容积分数、血管空间容积分数。观察上述参数在前列腺癌及前列腺增生中表现,通过ROC曲线评价其诊断价值,同时按照前列腺癌Gleason评分进行分组,比价参数间差异。结果观察组Ktrans、Kep、Vp、D*值高于对照组,而Ve、D、f值明显低于对照组(P<0.05)。DCE-MRI、IVIM-DWI各项定量参数诊断效能最高为D、f值。肿瘤Gleason评分越高,Kep、f值呈先大后小,D值减小,D*值增大(P<0.05)。结论IVIM-DWI联合DCE-MRI有助于诊断前列腺癌与前列腺增生,且IVIM-DWI优于DCE-MRI,IVIM-DWI参数中D值降低、D*值升高、f值由大到小表示高级别前列腺癌。

Assessment Value of IVIM-DWI Combined with Dynamic Enhanced MRI in the Diagnosis and Classification of Prostate Cancer

Objective To investigate the assessment value of IVIM-DWI combined with dynamic enhanced MRI in the diagnosis and classification of prostate cancer.Methods Forty-two patients with prostate cancer admitted to a Urological Surgery from March 2017 to April 2018 were enrolled as the subjects,andthirty-two patients with benign prostatic hyperplasia were used as a control group.IVIM-DWI and DCE-MRI were performed in both groups.The real diffusion coefficient,pseudo-diffusion coefficient,and perfusion fraction of IVIM-DWI parameters DCE-MRI parameter volume transfer Constant,rate constant,extravascular extracellular space volume fraction,vascular space volume fraction were obtained after image processing.The above parameters were observed in prostate cancer and benign prostatic hyperplasia.The diagnostic value was evaluated by the ROC curve.Simultaneously,grouping based on the Gleason score of prostate cancer,the differences between the parameters were compa red.Results The values of Ktrans,Kep,Vp,and D*in the observation group we re significantly higher than those in the control group,while the values of Ve,D and f were significantly lower than those in the control group(P<0.05).The D and f values were the highest in diagnostic performances of va rious quantitative para meters of DCE-MRI and IVIM-DWI.The higher the tumor Gleason score,the larger the Kep and f values increase then decrease,D value decreases and the D*value increases(P<0.05).Conclusion IVIM-DWI combined with DCE-MRI helps diagnose prostate cancer and benign prostatic hyperplasia,and IVIM-DWI is superior to DCE-MRI.The decreased IV value,the increased D*value,and the gradually increased f value of the IVIM-DWI parameters re present high-class prostate cancer.