摘要
目的比较1.5T磁共振波谱(MRS)和扩散加权成像(DWI)诊断前列腺癌的价值。方法根据前列腺组织穿刺结果,回顾性分析53例患者的MRS和DWI图像,相对应的274个感兴趣测量区包括活检确认为癌肿灶150个(实验组),良性增生灶124个(对照组)。对测量的MRS和DWI数据进行统计学分析,比较不同方法测得值在两组间的差异,并利用受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)对两种诊断方法进行比较。结果实验组和对照组在b=0、100、800s/mm2时的信号强度、表观扩散系数(apparent diffusion coefficient,ADC)、枸橼酸盐(Cit)含量积分、胆碱复合物(Cho)含量积分、胆碱(Cho)与肌酸(Cr)之和与Cit的比值〔(Cho+Cr)/Cit,CC/Cit〕的差异有统计学意义(P<0.05),根据ROC曲线,ADC值、b=800s/mm2时的信号强度以及CC/Cit比值鉴别前列腺癌和良性前列腺组织的能力明显优于其他几项指标。ADC值的最佳工作点为1.027×10-3 mm2/s,其特异度为0.887,敏感度为0.953,约登指数为0.84,曲线下面积为0.966;b=800s/mm2信号强度的最佳工作点为47.1,其特异度为0.806,敏感度为0.72,约登指数为0.53,曲线下面积为0.782;CC/Cit的最佳工作点为0.78,其特异度为0.806,敏感度为0.793,约登指数为0.60,曲线下面积为0.844。结论在1.5T场强下,用DWI特别是ADC值鉴别前列腺癌和良性前列腺组织,比MRS更具优势。
Objective To compare the clinical values of magnetic resonance spectroscopy(MRS)and diffusion weighted imaging(DWI)in diagnosing prostate cancer.Methods A 1.5T MR scanner was used in this study.We measured 274 regions of interest(ROI)in the images produced by MRS and DWI from 53 patients.The biopsy confirmed 150ROI as cancers and 124ROI as non-cancers.The results of MRS and DWI were compared using receiver operating characteristic(ROC)curves.Results Significant differences(P<0.05)between malignant and benign tumors were found in signal intensity(b=0,100,800s/mm2,in DWI),ADC value(in DWI),Cit content integral,Cho content integral and(Cho+Cr)/Cit ratio(in MRS).The ROC curves showed that ADC value,signal intensity(b=800s/mm2)and the ratio of(Cho+Cr)/Cit performed better in distinguishing prostate cancers from benign tumors.The optimal operating point(OOP)of ADC value was determined as 1.027×10-3 mm2/s,with0.887specificity,0.953sensitivity,0.84Youden index,and the area under curve(AUC)of 0.966.The OOP of signal intensity(b=800s/mm2)was determined as 47.1,with 0.806specificity,0.72sensitivity,0.53Youden index,and the AUCof 0.782;The OOP of(Cho+Cr)/Cit ratio was determined as 0.78,with 0.806specificity,0.793sensitivity,0.60Youden index,and the AUCof 0.844.Conclusion DWI is a better method than MRS in differentiating prostate cancers from benign tumors.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2013年第5期827-831,842,共6页
Journal of Sichuan University(Medical Sciences)
关键词
磁共振成像
磁共振波谱
扩散加权成像
表观扩散系数
前列腺癌
Magnetic resonance imaging Magnetic resonance spectrum Diffusion weighted imaging Apparent diffusion coefficient Prostate cancer
