IVIM-MRI对前列腺癌和前列腺增生的诊断价值
Diagnostic value of IVIM-MRI for the diagnosis of prostate cancer and benign prostatic hyperplasia
李泉霖 1张存美 2张晨晨 1王珊珊 3江洁1
作者信息
- 1. 山东中医药大学附属医院放射科 山东 济南 250011
- 2. 山东省滕州市中心人民医院影像中心 山东 枣庄 277500
- 3. 山东第一医科大学附属省立医院医学影像科 山东 济南 250021
- 折叠
摘要
目的 探讨体素内不相干运动扩散加权成像(intravoxel incoherent motion imaging,IVIM)在前列腺癌(prostate cancer,PCa)和前列腺增生(benign prostatic hyperplasia,BPH)的诊断价值.方法 选取因前列腺疾病在山东省立医院就诊的 100 例患者,其中经病理或随访证实的PCa患者 51 例、BPH患者 49 例.所得IVIM原始数据经软件包后处理,获得相应感兴趣区(ROI)单指数模型ADCmono 值和双指数模型ADCs 值、D* 值、f 值.结果 所有ROIs的ADCs值比AD-Cmono值显著降低(P<0.001).肿瘤(tumour,TU)ADCmono值及ADCs值比中央区(CG)、外周带(PZ)的ADCmono和ADCs值都减小且差异有统计学意义(P<0.001);TU的f值和D*变化比较大,TU D*值与PZ(P =0.231)、CG(P =0.389)的D*值比较差异无统计学意义(P>0.05);TU f值比PZ(P=0.041)、CG(P<0.001)的f值减小且差异有统计学意义(P<0.05).PCa和BPH比较,ADCmono的AUC值(area under the curve(AUC)为 0.987 大于ADCs(AUC=0.966)、D*(AUC =0.469)和f值(AUC=0.816);TU和PZ比较,ADCmono(AUC=0.999)和ADCs(AUC=1.000)的AUC值非常接近,大于D*(AUC=0.311)和f值(AUC=0.855).TU的ADCmono值(r=-0.761,P<0.05)和ADCs值(r=-0.666,P<0.05)随Gleason评分的升高呈降低趋势,两者呈负相关,ADCmono值相关性更强.结论 包含多个b值IVIM模型获得的ADCs排除微循环灌注成分的影响,表达真实的扩散,在鉴别前列腺疾病有很大的价值;肿瘤的灌注系数和灌注分数变化比较大,临床应用价值有限;肿瘤区的ADCmono和ADCs值与病理Gleason评分呈负相关,可为临床诊断和预后随访提供有利的帮助.
Abstract
Objective To evaluate the value of multi-b values double exponential intravoxel incoherent motion imaging(IVIM)mode analysis in the differential diagnosis between benign and malignant prostate lesions.Methods 51 patients with clinically diagnosed prostate cancer and 49 patients with benign prostatic hyperplasia(BPH)underwent abdomen T2-weighted imaging and diffusion-weighted imaging with nine diffusion-sensitive values.We collected them in Shandong Provincial Hospital.We acquired an apparent diffusion coefficient(ADCmono)from the monoexponential model and a diffusion coefficient(ADCs),perfusion coefficient(D*)and perfusion fraction(f)from the biexponential model.Results In all the ROIs,over the full range of b-values,the ADCmono from the monoexponential model was significantly higher than the ADCs from the biexponential model(P<0.001).Prostate cancer had lower ADCmono and ADCs than all the other tissues(P<0.01).The perfusion coefficients from the biexponential model showed a very large variation across this patient population.There were no significant differences between PZ and TU(P=0.231),CG and TU(P=0.389).The perfusion fraction of TU showed a large variation in the data across the patient population.Significant differences between the perfusion fractions(f)of PZ and TU(P=0.041),CG and TU(P<0.001)were detected.When distinguishing prostate cancer from BPH,the AUC of ADCmono was 0.987.It was higher than the ADCs value(AUC=0.966),D * value(AUC=0.469)and f value(AUC=0.816);When differing prostate cancer from PZ,the AUC value of ADCmono(AUC = 0.999)and ADCs(AUC = 1.000)were very similar,and they were higher than the D *(AUC = 0.311)and f(AUC = 0.855).TU ADCmono value(r=-0.767,P<0.05)and ADCs value(r=-0.666,P<0.05)showed a trend of lower with the increase of Gleason scores,and a negative relationship was found.Conclusions The IVIM model can get the ADCs data,which excludes the effect of perfusion from low b-values that can evaluate the actual diffusion of tissue.It is an important point when attributing clinical differences to diffusion within tissues.The ADCmono values and ADCs values of pros-tate cancer are negatively correlated with the Gleason scores,which can support evidence to diagnose and distinguish prostatic diseases,consequently,to monitor the prognosis of prostate cancer.
关键词
前列腺癌/前列腺增生/磁共振成像/体素内不均一运动Key words
Prostate cancer/Benign prostatic hyperplasia/Magnetic resonance imaging/Intravoxel incoherent motion imaging引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据