3.0T动态增强磁共振对前列腺癌的定量分析研究

目的：探讨3．0T磁共振动态增强（DCE-MRI）定量分析对前列腺癌的诊断价值，并评价Ktrans与Gleason评分的相关性。方法：回顾性分析40例经病理证实的前列腺疾病患者的病例资料，其中前列腺癌（PC）患者28例，前列腺增生（BPH）患者12例，每例患者均行常规MRI和DCE—MRI检查，通过与病理结果对照，在MRI图像上共选取130个样本，分为前列腺癌区、外周带非癌区和中央腺体非癌区三组，在前列腺定量参数伪彩图上取ROI并测量Ktrans、Ve及Kep值，对三组的各参数值分别行方差分析，并检验PC组Ktrans。值与Gleason评分的相关性。结果：前列腺癌区的Ktrans、ve及Kep值分别为（0．62±0．10）min-1、（0．44±0．12）和（1．45±0．25）min，外周带非癌区分别为（0．21±0．06）min-1、（0．29±0．65）和（0．76±0．21）min-1，中央区非癌区分别为（0．32±0．09）min、（0．34±0．70）和（0．95±0．26）min-1，Ktrans、Ve及Kep值在各组间差异均有统计学意义（F值分别为234．338、32．593及92．462，P值均〈0．05）；PC组Ktrans、Ve值在不同Gleason评分组间差异有统计学意义（F值分别为6．354、9．217，P值均〈0．05），Kep值在不同Gleason评分组间差异无统计学意义（P值〉0．05）；前列腺癌区的Ktrans值与Gleason评分呈正相关（r=0．533，P〈0．05）。结论：3．0TDCE-MRI定量分析研究能为PC的诊断提供客观依据。前列腺癌区的Ktrans值与Gleason评分呈正相关，提示定量参数Ktrans值可用于评估PC的恶性程度。

Quantitative diagnostic value of DCE-MRI in prostatic cancer

Objective：To study the diagnostic value of quantitative analysis parameters of DCE-MRI in the diagnosis of prostate cancer and to evaluate the correlation between Kt and Gleason scores. Methods： Forty patients with pathologically proved prostate diseases underwent conventional MRI and DCE-MR examinations. They were divided into three groups ： cancerous loci, noncancerous area in the peripheral zone and central gland. ROIs were drawn on areas of prostate tissue to measure the values of Ktrans, Vo and Kep. The 3 parameters in the different groups were analyzed, and the correlations between K and Gleason scores were studied. Results：The Ktrans ,Ve and Kep valuesof cancerous loci were （0.62±0.10）/min, （0.44 ± 0. 12） and （ 1.45± 0. 25 ）/min, respectively, while, for noncancerous area in the peripheral zone were （0. 21± 0.06）/min, （0.29 ± 0.65 ）, （0.76±0.21）/min, respectively, and for noncancerous area in the central gland were （0.32 ± 0.09）/rain, （0.34±0.70）, （0.95±0.26 ）/min, respectively. The differences between K , Vo and Kep values of the three groups were statistically significant （F= 234. 338,32. 593 and 92. 462, respectively; P〈0.05）. Significant correlation was found between K and Gleason score （r= 0. 533, P〈0.05）. Conclusion： The differences of K , Vo and Kep among the three groups （cancerous foci,noncancerous area in the peripheral zone and central gland） are statistically significant. 3.0T DCE-MRI quantitative analysis plays an important role in the diagnosis of prostate cancer. Positive correlation is found be- tween K and Gleason score. Ktrans can be used for evaluating the degree of malignancy of prostate cancer.