扩散加权成像诊断前列腺中央腺体癌

目的探讨根据DWI所得ADC值诊断前列腺中央腺体癌的标准。方法回顾性分析27例前列腺中央腺体癌患者(前列腺中央腺体癌组)和62例良性前列腺增生患者(良性前列腺增生组)的资料,测量两组患者的ADC值,绘制ROC曲线,寻找最佳临界点,确定中央腺体癌的ADC值的诊断标准。结果①中央腺体ADC值:前列腺中央腺体癌组为(1.22±0.20)×10-3mm2/s,良性前列腺增生组为(1.51±0.14)×10-3mm2/s,差异有统计学意义(t=-6.862,P<0.001);根据ROC分析,Youden指数最大为0.656,最佳临界点为1.316×10-3mm2/s,此时诊断前列腺中央腺体癌的敏感度为70.40%,特异度为95.20%,准确率为87.64%。②最小ADC值:前列腺中央腺体癌组为(0.82±0.16)×10-3mm2/s,良性前列腺增生组为(1.15±0.11)×10-3mm2/s,差异有统计学意义(t=-9.416,P<0.001);根据ROC分析,Youden指数最大为0.762,最佳临界点为0.953×10-3mm2/s,此时诊断前列腺中央腺体癌的敏感度为77.80%,特异度为98.40%,准确率为92.13%。结论制定ADC值标准有助于DWI诊断前列腺中央腺体癌。

Diagnosis of diffusion-weighted imaging for prostatic central gland cancer

Objective To explore the diagnostic criteria of the ADC value on DWI in prostatic central gland cancer.Methods Clinical and imaging data of 89 patients including 27 cases of prostatic central gland cancer(prostatic central gland cancer group) and 62 cases of benign prostate hyperplasia(BPH group) were analyzed retrospectively.ADC values of the two groups were measured.ROC curve was depicted to determine the cutoff point for the prostatic central gland cancer detection with the ADC value.Results ①The mean ADC value in prostatic central gland cancer group and BPH group was(1.22±0.20)×10-3 mm2/s and(1.51±0.14)×10-3 mm2/s,respectively(t=-6.862,P<0.001).According to the ROC analysis,the diagnostic sensitivity,specificity and accuracy was 70.40%,95.20% and 87.64% when the cutoff point was 1.316×10-3 mm2/s,while the maximal Youden’s index was 0.656.②The mean minimal ADC value in prostatic central gland cancer group and BPH group was(0.82±0.16)×10-3 mm2/s and(1.15±0.11)×10-3 mm2/s,respectively(t=-9.416,P<0.001).According to the ROC analysis,the diagnostic sensitivity,specificity and accuracy was 77.80%,98.40% and 92.13% when the cutoff point was 0.953×10-3 mm2/s,while the maximal Youden’s index was 0.762.Conclusion With the criteria of the ADC value,DWI can be used in diagnosis of prostatic central gland cancer.