基于全瘤容积测量的ADC值直方图在前列腺癌的诊断价值

目的 探讨全瘤容积测量的表观扩散系数(ADC)值直方图在诊断前列腺癌的价值,筛选出最佳诊断参数值.方法 回顾分析经穿刺活检或手术病理证实的前列腺癌31例,良性前列腺增生结节35例,治疗前均行扩散加权成像(DWI)检查,b=0、1500 s/mm2.测量全瘤的ADC值直方图参数,包括ADC平均值(ADCmean)、ADC中位数(ADCmedian)、ADC第10百分位数(ADC10th)、ADC第25百分位数(ADC25th)、ADC第50百分位数(ADC50th)、ADC第75百分位数(ADC75th)、ADC第90百分位数(ADC90th)、偏度值及峰度值.分析比较2组患者的直方图参数值及其诊断效能.结果 前列腺癌组的ADCmean、ADCmedian、ADC10th、ADC25th、ADC50th、ADC75th、ADC90th均低于良性前列腺增生组(P值均<0.01),2组疾病的偏度值和峰度值差异无统计学意义(P值均>0.05).ADCmean、ADCmedian、ADC10th、ADC25th、ADC50th、ADC75th、ADC90th诊断前列腺癌的受试者工作特征(ROC)曲线的曲线下面积(AUC)均>0.78,其中ADC10th诊断效能最佳,其AUC为0.82,最佳截断点值为0.27×10-3 mm2/s,敏感性和特异性分别为78.4％和83.3％.结论 全瘤容积测量的 ADC 值直方图诊断前列腺癌具有较大价值,可鉴别前列腺癌和良性前列腺增生结节,其中 ADC10th 诊断效能最高.

Diagnostic value of ADC histogram based on total tumor volume measurement in prostate cancer

Objective To investigate the value of ADC histogram of tumor volume measurement in the diagnosis of prostate cancer,and to screen out the best diagnostic parameter value.Methods 31 cases of prostate cancer and 35 cases of benign prostatic hyperplasia confirmed by biopsy or surgical pathology were analyzed retrospectively.DWI examination was performed on all patients before treatment,and b value of 0 and 1500 s/mm2 was selected.The total tumor ADC histogram parameters were measured respectively,including the average value of ADC (ADCmean ),the median ADC (ADCmedian ),the tenth percentile ADC (ADC10th),the twenty-fifth percentile ADC (ADC25th), the fiftieth percentile ADC (ADC50th),the seventy-fifth percentile ADC (ADC75th),the ninetieth percentile ADC (ADC90th), skewness and kurtosis.The histogram parameters of the two groups of patinents and their diagnostic efficacy were analyzed and compared.Results ADCmean ,ADCmedian ,ADC10th,ADC25th,ADC50th,ADC75th and ADC90th in the prostate cancer group were statistically lower than those of benign prostatic hyperplasia group (P <0.01),and there was no significant difference in the skewness and kurtosis between the two groups of diseases (P > 0.05 ).ADCmean ,ADCmedian ,ADC10th,ADC25th,ADC50th,ADC75th and ADC90th diagnosing prostate cancer in the area under ROC curves (AUC)were more than 0.78.ADC10th had the best diagnostic efficacy and its AUC was 0.82, with the optimal cut-off value for 0.27 × 10 -3 mm2/s,with sensitivity and specificity for 78.4％ and 83.3％.Conclusion The ADC histogram of the total tumor volume measurement is of great value in the diagnosis of prostate cancer,among which ADC10th is the most effective parameter.It can accurately distinguish between prostate cancer and prostatic hyperplasia nodules.