河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (4): 444-447,453.doi: 10.3969/j.issn.1007-3205.2021.04.016

• • 上一篇    下一篇

DCE-MRI、表观扩散系数对前列腺癌分级诊断的应用比较

  

  1. 河北省保定市第一中心医院医学影像一科，河北 保定 071000
  • 出版日期:2021-04-25 发布日期:2021-04-29
  • 作者简介:张杰（1984-），男，河北保定人，河北省保定市第一中心医院主治医师，医学学士，从事影像学诊断研究。
  • 基金资助:
    河北省自然科学基金项目（17CYBJC15108）

Comparison of application of DCE-MRI and apparent diffusion coefficient to classification diagnosis of prostate cancer

  1. The First Department of Medical Imaging， the First Central Hospital of Baoding, Hebei Province, Baoding 071000, China
  • Online:2021-04-25 Published:2021-04-29

HTML

PDF (PC)

67

摘要： 目的  探讨动态增强磁共振成像（dynamic contrast-enhanced magnetic resonance imaging，DCE-MRI）、表观扩散系数（apparent diffusion coefficient，ADC）对前列腺癌分级诊断的应用比较。
方法  选取我院收治的前列腺癌患者76例进行回顾性分析。根据Gleason评分，将前列腺患者分成低中危组（Gleason评分＜8分）及高危组（Gleason评分≥8分），每组分别为50例、26例。所有患者均进行前列腺DCE-MRI及扩散加权成像（diffusion-weighted imaging，DWI）检查，比较2组患者的DCE-MRI参数、ADC水平及在不同扩散敏感系数下的DWI信号强度值，采用受试工作特征（test operating characteristics，ROC）曲线分析DCE-MRI各参数、ADC对前列腺癌分级诊断的临床价值。
结果  在不同扩散敏感系数下，低中危组的DWI信号强度值和ADC值显著高于高危组（P＜0.05）。低中危组患者的Kep、Ve水平显著高于高危组（P＜0.05），但是2组患者在Ktrans、Kep值上差异无统计学意义（P＞0.05）。采用ROC曲线分析Ktrans、Vp及ADC 2组患者的水平差异，结果显示：Ktrans、Vp及ADC的曲线下面积分别为0.738、0.294、0.645，最佳临界值分别为1.720（min）、0.366、85.825（10-5mm2/s），敏感度分别为92.1%、89.6%、93.1%，特异度分别为55.0%、62.7%、80.2%。
结论  DCE-MRI、ADC对前列腺癌分级均具有较高的诊断价值，且ADC的诊断价值优于DCE-MRI。


关键词: 前列腺肿瘤, 磁共振成像, 诊断, 计算机辅助

Abstract: Objective  To compare the application of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) and apparent diffusion coefficient(ADC) in the classification diagnosis of prostate cancer. 
Methods  A total of 76 patients with prostate cancer treated in our hospital were retrospectively analyzed. According to the Gleason score, prostate cancer patients were divided into low-to-moderate-risk group(Gleason score ＜8 points, n=50) and high-risk group(Gleason score≥8 points). All patients underwent prostate DCE-MRI and diffusion-weighted imaging(DWI) examinations. DCE-MRI parameters, ADC levels, and DWI signal strength values under different diffusion sensitivity coefficients were compared between the two groups of patients. The receiver operating characteristics(ROC) curve was used to analyze clinical value of DCE-MRI parameters and ADC for classification diagnosis of prostate cancer. 
Results  Under different diffusion sensitivity coefficients, the DWI signal strength values and ADC values in the low-to-moderate-risk group were significantly higher than those in the high-risk group(P＜0.05). The levels of Kep and Ve in patients with low-to-moderate-risk group were significantly higher than those in high-risk group(P＜0.05), but there was no significant difference in Ktrans and Kep values between two groups(P＞0.05). The ROC curve was used to analyze the difference in the levels of Ktrans, Vp, and ADC between two groups. The results showed that the areas under the curve of Ktrans, Vp, and ADC were 0.738, 0.294, and 0.645, respectively, and the optimal cutoff values were 1.720（min）, 0.366, and 85.825（10-5mm2/s）, respectively. The sensitivity was 92.1%, 89.6%, and 93.1%, respectively and the specificity was 55.0%, 62.7%, and 80.2%, respectively. 
Conclusion  Both DCE-MRI and ADC have higher diagnostic value for the classification of prostate cancer, and the diagnostic value of ADC is better than DCE-MRI.


Key words: prostatic neoplasms, magnetic resonance imaging, diagnosis, computer-assisted

版权所有 © 《河北医科大学学报》编辑部
本系统由北京玛格泰克科技发展有限公司设计开发