动态增强MRI鉴别诊断前列腺中央腺体T2WI低信号病变

目的 观察动态增强MRI （DCE-MRI）定量及半定量参数鉴别诊断前列腺中央腺体T2WI低信号病变的价值。方法 收集59例存在前列腺中央腺体T2WI低信号病变患者，其中前列腺癌患者32例（前列腺癌组），前列腺增生伴慢性炎症患者15例（增生伴慢性炎症组），高级别上皮内瘤变（HGPIN）患者12例（HGPIN组），测量并比较其DCE-MRI定量及半定量参数：容积转运常数（K^trans）、速率常数（K_ep）、血管外细胞外容积分数（V_e）、对比剂血浆容积（V_p）、达峰时间（TTP）、最大浓度（Conc_max）、最大斜率（Slope_max）和时间-浓度曲线下面积（AUTC），绘制ROC曲线，分析各参数诊断前列腺癌的效能。结果 前列腺癌组、增生伴慢性炎症组与HGPIN组间K_trans、K_ep、V_e、V_p、TTP及Slope_max差异均有统计学意义（P均<0.05），其中前列腺癌组与HGPIN组间K^trans、K_ep、V_e、Slope_max及TTP差异均有统计学意义（P均<0.05），前列腺癌组与增生伴慢性炎症组间V_p及TTP差异有统计学意义（P均<0.05），HGPIN组与增生伴慢性炎症组间K^trans、K_ep、V_p及TTP差异均有统计学意义（P均<0.05）。ROC曲线显示TTP、K^trans及K_ep值诊断前列腺癌的曲线下面积（AUC）分别为0.743、0.735和0.721，两两比较差异均无统计学意义（P均>0.05），但均大于V_e值诊断前列腺癌的AUC （P均<0.05）。结论 DCE-MRI参数TTP、K^trans和K_ep可于前列腺中央腺体T2WI低信号病变中有效鉴别诊断前列腺癌。

Dynamic contrast-enhanced MRI in differential diagnosis of T2WI low signal lesions in central gland of prostate

Objective To explore the value of dynamic contrast-enhanced MRI (DCE-MRI) quantitative and semi-quantitative parameters in differential diagnosis of T2WI low signal lesions in central gland of prostate.Methods A total of 59 patients with low T2WI lesions in central gland of prostate were collected, including 32 patients of prostate cancer (prostate cancer group), 15 patients of hyperplasia associated with chronic inflammation (hyperplasia with chronic inflammation group) and 12 patients of high-grade intraepithelial neoplasia (HGPIN, HGPIN group). DCE-MRI quantitative and semi-quantitative parameters were measured and compared, including volume transfer constant (K^trans), rate constant (K_ep), extravascular extracellular volume fraction (V_e), plasma volume of contrast agent (V_p), time to peak (TTP), maximum concentration (Conc_max), maximum slope (Slope_max) and area under the time concentration curve (AUTC). The ROC curve was used to analyze the efficacy of each parameter in diagnosis of prostate cancer.Results K^trans, K_ep, V_e, V_p, TTP and Slope_maxvalue were statistically different among three groups (all P<0.05). K^trans, K_ep, V_e, Slope_max and TTP values were significantly different between prostate cancer group and HGPIN group. V_p and TTP values were significantly different between prostate cancer group and hyperplasia with chronic inflammation group. K^trans, K_ep, V_p and TTP values were significantly different between HGPIN group and hyperplasia with chronic inflammation group. ROC curve showed that the area under the curve (AUC) of TTP, K^trans and K_ep values (0.743, 0.735 and 0.721) was larger than that of V_evalue (all P<0.05), respectively. But there was no statistical difference between each of them (all P>0.05).Conclusion The parameters TTP, K^trans and K_ep of DCE-MRI can effectively differentiate prostate cancer from other T2WI hypointense lesions in the central gland of prostate.