摘要
目的探讨DWI的ADC值诊断中、高级别前列腺癌的价值。方法回顾性分析经穿刺活检证实为前列腺癌，穿刺Gleason评分（Gs）≤3＋3=6，并进行了前列腺癌根治术的54例患者资料。患者均行前列腺DWI检查。以前列腺癌根治术病理标本为参照，选择T：WI上相应部位的低信号区，放置ROI，测定病灶ADC值。根据前列腺癌根治术标本GS，将穿刺GS≤3＋3=6患者分为中、高级别前列腺癌（Gleason分级含4或5级）和低级别前列腺癌（Gleason分级不含4或5级）2组。采用独立样本t检验比较2组患者前列腺癌灶ADC值的差异，采用ROC曲线分析以前列腺癌灶ADC值区分穿刺GS≤3＋3=6患者中、高级别癌和低级别癌的效能。结果中、高级别前列腺癌28例，低级别前列腺癌26例。中、高级别前列腺癌癌灶的ADC值为（0．905±0．162）×10^-3mm^2／s，低级别前列腺癌的ADC值为（1．143±0．165）×10^-3mm2／s，差异有统计学意义（f=5．361，P〈0．01）。ADC值区分前列腺中、高级别癌和低级别癌的ROC曲线下面积为0．861，以ADC=1．000×10^-3mm2／s为界值时，诊断的敏感度和特异度分别为88．5％和67．9％。结论对于穿刺GS≤3＋3=6的前列腺癌患者，前列腺癌灶ADC值有助于识别其中的中、高级前列腺癌。
Objective To evaluate the utility of apparent diffusion coefficient （ADC） values from DWI in identifying intermediate and high grade prostate cancer （patients harboring Gleason 4 and/or 5 components in their radical prostatectomy specimens）. Methods We retrospectively analyzed the DWI of 54 patients with biopsy-proven prostate cancer and biopsy Gleason score （GS） ≤3＋3=6. These patients were divided into two groups, intermediate and high grade prostate cancer （patients harboring Gleason 4 and/or 5 components in their radical prostatectomy specimens） and low-grade prostate cancer （patients not harboring Gleason 4 and/or 5 components in their radical prostatectomy specimens）. ROIs were drawn on areas of the most suspicious lesion on T2WI and the ADC values were calculated. The ADC values of the two groups were compared to determine whether there were differences between them with independent-sample t test. Receiver operating characteristic （ROC） curve was used to determine the ability of ADC values in differentiating intermediate/high grade prostate cancer from low-grade prostate cancer. Results Twenty-eight patients had intermediate and high grade prostate cancer while the other twenty-six ones had low-grade prostate cancer. Significant differences were found for the ADC values of these two groups [（0.905±0.162）×10^3mm^2/s vs. （1.143±0.165）×10^-3mm^2/s, t=5.361,P〈0.01]. The area under the ROC curve of ADC in differentiating intermediate and high grade prostate cancer from low-grade prostate cancer was 0.861, with sensitivity of 88.5% and specificity of 67.9% at the cut-off of 1.000×10^-3mm^2/s. Conclusion The ADC values of suspicious areas in prostate contribute to identify intermediate/high grade prostate cancer in patients with a GS≤3＋3=6 on biopsy.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2016年第1期18-21,共4页
Chinese Journal of Radiology
基金
医学影像科国家临床重点专科建设项目（国卫办医函[2013]544号）
关键词
前列腺肿瘤
磁共振成像
对比分析
Prostate neoplasms
Magnetic reasonance imaging
Comparative study
