MR扩散加权成像对前列腺癌Gleason评分预估价值的研究

目的初步探讨DWI检查的ADC值对前列腺癌Gleason评分的预估价值。方法回顾性分析21例经超声引导下穿刺活检确诊为前列腺癌的患者，分别测得每例患者兴趣区的ADC值，在超声引导下穿刺兴趣点，获得相应的Gleason评分，将ADC值与穿刺病理的Gleason评分结果进行对照，通过Spearman相关分析探讨两者的相关性。结果21例患者共计测得84个兴趣区域的ADC值，每例患者分别计算其平均ADC值，经Spearman相关分析，ADC值与对应区的Gleason评分呈负相关（r=-0．578，P=0．01）。Gleason评分〈7的高分化癌组的ADC值平均为（O．821±0．128）×10^-2mm。／s，Gleason评分i〉7的中低分化癌组的ADC值平均为（0．644±0．149）×10^-1mm。／s，两组间差异有统计学意义（t：3．12，P=0．01）。结论ADC值与Gleason评分呈负相关，DWI可用于前列腺癌Gleason评分的预估。

The preliminary study of using diffusion - weighted imaging to predict Gleason score of prostate cancer

Objective To investigate the value of using the ADC values derived by diffusion - weighted imaging（DWI） to predict the Gleason grading of prostatic cancer. Methods The clinical data of 21 cases by ultrasound guided puncturing biopsy in patients diagnosed with prostate cancer were retrospectively analyzed. By respectively measuring the ADC values of each patientg interest area, under ultrasound guided puncture point of interest, the corresponding Gleason score was obtained, and the ADC values were compared with the result of Glea- son score. For investigating their correlation, Spearman correlation analysis was applied. Results A total of 84 regions with valid pathologic diagnosis were obtained. The average ADC values of each patient were calculated. Spearman rank correlation analysis revealed that the ADC values of the prostatic carcinoma had significant negative correlation with Gleason scores （ r = - 0. 578,P = 0.01 ）. In the well - differentia ted carcinoma group （Gleason score 〈 7 ） , the mean ADC value was （0. 821 ± 0. 128） x 10-3 mm2/s. However, in poorly differentiated carcinoma group （ Gleason score i〉7） , the mean ADC value was（0. 644 ± 0. 149 ） x 10-3 mm2/s. There was significant statistical differ- ence between the two groups （ t = 3.12, P = 0.01 ）. Conclusion ADC values have negative correlation with Gleason scores. DWI may be used to predict the Gleason scores of prostate cancer.