摘要
目的 评价磁共振弥散加权成像(DWI)在前列腺癌诊断及鉴别诊断中的应用价值。方法 53例前列腺特异性抗原(PSA)异常、直肠指检或超声异常的疑似前列腺癌患者，术前行DWI检查，对比术后病理结果，分析其表观弥散系数(ADC)值。结果 术后病理检查发现前列腺癌15例，前列腺增生37例，上皮内瘤变1例。在弥散敏感系数(b)值1 000s/mm2下前列腺癌组癌区与前列腺增生组外周带ADC值分别为(0.813 ±0. 25)×10-3 mm/s与(1.45±0.24)×10-3mm/s,两者差异有统计学意义（t=-26.117,P＜0.01）。在b值600 s/mm2下前列腺癌组癌区与前列腺增生组外周带ADC值分别为(1. 03±0. 27)×10-3 mm/s与(1.62±0.33)×10-3 mm/s,两者差异有统计学意义（t=-24.191,P＜0.01）。DWI的接受者操作特性(ROC)曲线下面积为0.862，敏感性与特异性分别为78.1％及91.5％。结论 DWI可为前列腺癌的鉴别诊断提供量化信息，具有较好的临床应用价值。
Abstract
Objective To evaluate the application value of magnetic resonance diffusion weighted imaging (DWI)in diagnosis and differential diagnosis of prostate cancer. Methods 53 Cases of suspected prostate cancer patients with elevated prostate-specific antigen, abnormal digital rectal examination or ultrasound examination were underwent DWI examination before operation. Apparent dispersion coefficient was measured and compared to pathological results. Results There were 15 cases of prostate cancer, 37 cases of benign prostate hyperplasia and one prostatic intraepithelial neoplasia. When b =1 000 s/mm2 ,the ADC values of foci area in prostate cancer group and peripheral zone in benign prostate hyperplasia group were (0.813 ±0.25) × 10-3mm/8 and (1.45±0.24) × 10-3mm/s respectively, and the difference had statistical significance(t =-26. 117,P ＜0. 01 ). When b =60D s/mm2, the ADC values of foci area in prostate cancer group and peripheral zone in benign prostate hyperplasia group were ( 1.03 ± 0. 27) × 10-3 mm/s and ( 1.62 ± 0. 33) × 10- 3 mm/s respectively, and the difference had statistical significance( t =- 24. 191, P ＜ 0. 01 ). The area under the ROC curves was 0.862, and the sensitivity and specificity of DWI were 78.1％ and 91.5％ respectively.Conclusion DWI can provide quantitative information for prostate cancer diagnosis and differential diagnosis,therefore it possesses a good clinical application value.
NETL
NSTL
维普
万方数据