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目的探讨3.0 T磁共振弥散加权成像(diffusion-weighted imaging,DWI)对前列腺癌的诊断和鉴别诊断价值。方法应用3.0 T MR成像仪对36例前列腺特异抗原升高疑有前列腺癌的患者进行前列腺MRI高分辨成像及单次激发EPI序列的弥散加权成像,b值分别取0、1000 s/mm2。将前列腺外周带以六分区划分,观察T2WI图及DWI图,并测定各区的表观弥散系数(apparent diffusion coefficient,ADC)值。所有患者均行超声引导下系统穿刺活检证实,依病理结果将其分为前列腺癌区、良性前列腺增生区及慢性炎症区。对所得数据进行统计分析。结果 14例前列腺癌、20例良性前列腺增生及2例慢性前列腺炎患者获得可靠ADC值。与良性前列腺增生的ADC值[(1.72±0.28)×10-3mm2/s]比较,前列腺癌的ADC值明显减低[(1.13±0.31)×10-3mm2/s],差异具有统计学意义(P<0.001)。ROC曲线上临界点取1.31×10-3mm2/s时,癌和非癌鉴别诊断的敏感性为61.0%,特异性为85.7%。结论 3.0 T DWI的ADC值有助于前列腺癌的鉴别诊断。
Objective To investigate the value of 3.0 T magnetic resonance diffusion-weighted imaging (DWI) in the diagnosis and differential diagnosis of prostate cancer. METHODS: Thirty-six patients with suspected prostate cancer who had elevated prostate specific antigen were subjected to high-resolution MRI imaging and diffusion-weighted imaging of single-shot EPI sequence using a 3.0 T MR imager. The b values were taken as 0,1000 s / mm 2, respectively. The peripheral zone of the prostate was divided into six regions. The T2WI and DWI images were observed and the apparent diffusion coefficient (ADC) value of each region was determined. All patients underwent ultrasound guided biopsy confirmed by the pathological results will be divided into prostate cancer area, benign prostatic hyperplasia and chronic inflammation area. The resulting data for statistical analysis. Results A reliable ADC value was obtained in 14 cases of prostate cancer, 20 cases of benign prostatic hyperplasia and 2 cases of chronic prostatitis. The ADC value of prostate cancer was significantly lower than that of benign prostatic hyperplasia [(1.72 ± 0.28) × 10-3mm2 / s] [(1.13 ± 0.31) × 10-3mm2 / s], P < <0.001). When the critical point of ROC curve is taken as 1.31 × 10-3mm2 / s, the sensitivity and specificity of differential diagnosis of cancer and non-cancer are 61.0% and 85.7% respectively. Conclusion The ADC value of 3.0 T DWI contributes to the differential diagnosis of prostate cancer.