动态增强磁共振成像定量参数联合表观扩散系数值对外周带前列腺癌的诊断价值研究
Study on the Diagnostic Value of Quantitative Parameters of Dynamic En-hanced Magnetic Resonance Imaging Combined with Apparent Diffusion Coefficient Values for Peripheral Prostate Cancer
刘婷婷 1王晓辉 1王洪兴 1潘锋 1李昊 1胡海峰2
作者信息
- 1. 100076 北京,北京航天总医院影像中心
- 2. 161006 黑龙江齐齐哈尔,齐齐哈尔医学院附属第二医院影像科
- 折叠
摘要
目的 探究动态增强磁共振成像(DCE-MRI)定量参数联合表观扩散系数(ADC)值诊断外周带早期前列腺癌的价值.方法 选取2019 年2 月至2021 年12 月经穿刺病理学检查确诊为外周带早期前列腺癌31 例和前列腺炎27 例为研究对象.患者均进行DCE-MRI定量参数检查,以病理学检查结果为金标准,分析不同患者的DCE-MRI特征.并采用受试者工作特征曲线下面积(AUC)分析基于DCE-MRI定量参数与扩散加权成像(DWI)序列对外周带早期前列腺癌与前列腺炎的诊断价值.结果 31 例前列腺癌患者中,T2 加权成像(T2WI)以外周带结节状低信号为主,占58.06%;DWI以结节状、弥漫性高信号,ADC值下降为主,占 51.61%;DCE-MRI可见病灶早期强化,以延迟后病灶造影剂退出,强化曲线呈流出型为主,占64.52%.27 例前列腺炎患者中,T2WI以外周带单侧或双侧弥漫性不均匀低信号为主,占51.85%;DWI可见外周带单侧或双侧不规则高信号,ADC值降低为主,占 59.26%;DCE-MRI可见病灶早期强化,以延迟后造影剂退出不明显,强化曲线呈流入型为主,占81.48%.外周带早期前列腺癌患者ADC值低于前列腺炎,速率常数(Kep)值、转移常数(Ktrans)高于前列腺炎(P＜0.05).DCE-MRI定量参数联合ADC值诊断外周带早期前列腺癌的 AUC 为 0.862(95%CI:0.659,0.865)、敏感度为 87.10%,特异度为 81.48%,准确度为84.48%,阳性预测值为84.38%,阴性预测值为84.62%.结论 DCE-MRI定量参数联合ADC值对外周带早期前列腺癌的诊断效能良好,能显著提高临床检出率,为疾病的诊断与治疗提供依据.
Abstract
Objective To explore the value of combined quantitative parameters of dynamic contrast-enhanced mag-netic resonance imaging(DCE-MRI)combined with apparent diffusion coefficient(ADC)values in the diagnosis of early pe-ripheral prostate cancer.Methods In total,31 patients with early peripheral prostate cancer diagnosed by biopsy pathology from February 2019 to December 2021 and 27 patients with prostatitis were selected.All patients underwent DCE-MRI exami-nation for quantitative parameters,and the pathological examination results were used as the gold standard to analyze the DCE-MRI characteristics of different patients.The area under receiver operating characteristic(ROC)curve(AUC)was used to analyze the diagnostic value of quantitative parameters of DCE-MRI and diffusion weighted imaging(DWI)sequences for early peripheral prostate cancer and prostatitis.Results In 31 patients with prostate cancer,T2-weighted imaging(T2WI)mainly showed nodular low signal in peripheral zone,accounting for 58.06%.DWI was characterized by nodular and diffuse high sig-nal,and ADC value decreased,accounting for 51.61%.DCE-MRI showed early enhancement of the lesion,with the with-drawal of contrast agent after delay,and the enhancement curve was mainly outflow type,accounting for 64.52%.In 27 pa-tients with prostatitis,unilateral or bilateral diffuse low signal in peripheral zone was the main feature on T2WI,accounting for 51.85%.In DWI,the irregular high signal of peripheral band was found on one or both sides,and ADC value decreased mainly,accounting for 59.26%.DCE-MRI showed early enhancement of the lesion,and the contrast agent withdrawal was not obvious after delay,and the enhancement curve was mainly inflow type,accounting for 81.48%.The ADC value of early pe-ripheral prostate cancer was lower than that of prostatitis,and the rate constant(Kep)and metastasis constant(Ktrans)were higher than those of prostatitis(P＜0.05).The AUC of quantitative parameters of DCE-MRI combined with ADC value in the diagnosis of early peripheral prostate cancer was 0.862(95%CI:0.659,0.865),with sensitivity of 87.10%,specificity of 81.48%,accuracy of 84.48%,positive predictive value of 84.38%,and negative predictive value of 84.62%.Conclusion Quantitative parameters of DCE-MRI combined with ADC values are effective in the diagnosis of early peripheral prostate cancer,which can significantly improve the clinical detection rate and provide a reference for the diagnosis and treat-ment of the disease.
关键词
前列腺肿瘤/前列腺炎/动态增强磁共振成像/扩散加权成像/病理学/诊断/受试者工作特征曲线/曲线下面积Key words
Prostatic neoplasms/Prostatitis/Dynamic contrast-enhanced magnetic resonance imaging/Diffusion-weighted imaging/Pathology/Diagnosis/Receiver operating characteristic curve/Area under the curve引用本文复制引用
基金项目
2020年度黑龙江省省属高等学校基本科研业务费科研项目(2020-KYYWF-0031)
出版年
2024
国家科技期刊平台
NSTL
万方数据