双参数MRI纹理分析鉴别诊断移行区前列腺癌及增生结节的价值

目的探讨双参数MRI纹理分析法在移行区前列腺癌及增生结节鉴别诊断中的应用价值。方法回顾性分析经病理证实的前列腺癌52例,增生结节39例。使用MRIcroN软件勾画病灶的范围,Matlab R2014b软件计算各纹理参数,用Fisher法选择独立纹理特征(包括方差,熵,偏度和峰度)及平均ADC值。使用两独立样本t检验评估各纹理参数及平均ADC值是否具有统计学差异。绘制受试者工作特征曲线并计算曲线下面积、敏感度和特异度。结果T 2WI前列腺癌组的方差低于增生组,熵高于增生组。ADC图前列腺癌组的方差和平均ADC值低于增生组,偏度、峰度、熵高于增生组。T 2WI熵联合ADC图熵的诊断价值最高(AUC=0.880),敏感度和特异度分别为73.7%,90.9%。结论T 2WI联合ADC图双参数纹理分析可准确区分前列腺癌与低信号增生结节,为两者的鉴别诊断提供客观、量化的依据。

Bi-parametric MRI imaging texture analysis for the differential diagnosis of transitional zone prostate cancer and hyperplasia nodules

Objective To investigate the value of bi-parametric MRI texture analysis in differential diagnosis of transitional prostate cancer and T 2WI low-signal hyperplastic nodules.Methods Thirty-nine patients with transitional prostate cancer confirmed by pathology and fifty-two patients with low-signal hyperplastic nodules on T 2WI were retrospectively analyzed.All patients underwent routine prostate MRI,DWI,and enhanced T 1WI.MRIcroN software was used to delineate the extent of the lesion in the area corresponding to the pathological results.Matlab R2014b software was used to calculate the texture parameters(variance,entropy,skewness,and kurtosis)and average ADC values.Two independent samples t-tests were used to assess whether the difference in texture parameters and mean ADC values.The receiver operating characteristic curve(ROC),the area under the curve(AUC),sensitivity and specificity were calculated.Results The variance of T 2WI prostate cancer group was lower than the hyperplasia group,and the entropy was higher than the hyperplasia group.The difference was statistically significant.The variance and mean ADC value of the ADC sequence in the prostate cancer group were lower than those in the hyperplasia group.Skewness,kurtosis,and entropy were higher than those in the proliferative group.The difference was statistically significant.The diagnostic value of entropy of T 2WI sequence combined with entropy of ADC sequence was the highest(AUC=0.880).The sensitivity and specificity were 73.7%and 90.9%,respectively.Conclusion The bi-parametric MR texture analysis of T 2WI combined with ADC sequence can accurately distinguish between prostate cancer and low-signal hyperplastic nodules,thereby providing an objective and quantitative basis for the differential diagnosis of both.