摘要
目的:探讨MRI弥散加权成像(diffusion weighted imaging,DWI)对前列腺癌的诊断价值及其ADC平均值与前列腺癌危险程度的相关性,为评估前列腺癌的危险程度提供影像学数据。方法:收集经组织病理学确诊的前列腺癌患者41例为实验组、前列腺增生患者56例为对照组,2组患者在术前均行DWI扫描,采用独立样本t检验比较2组前列腺组织的表观弥散系数(apparent diffusion coefficient,ADC)平均值、信号强度值及动态对比增强MRI(dynamic contrast enhanced MRI,DCE-MRI)参数[组织间隙-血浆速率常数(Kep)、转运常数(Ktrans)和细胞外间隙体积分数(Ve)]。根据PSA(前列腺特异抗原)值、Gleason评分和术后TNM分期,将前列腺癌组分为低危组、中危组和高危组,采用多因素方差分析比较组间的参数差异,采用Spearman等级相关性分析分析前列腺癌危险程度与各参数的相关性。结果:实验组的ADC平均值以及b=800、50 s/mm^2时的信号强度值分别为(76.02±16.24)、(106.27±28.36)、(92.89±16.17)mm^2/s,均明显低于对照组,差异均具有统计学意义(P<0.05);实验组的Kep、Ve及Ktrans值分别为(0.83±0.07)min^(-1)、(0.39±0.08)%、(0.42±0.06)min^(-1),均高于对照组,2组比较有统计学差异(P<0.05);ADC平均值与前列腺癌危险程度呈强负相关(r=-0.689,P=0.00);前列腺癌低危组、中危组和高危组组间ADC平均值差异有统计学意义(P<0.05),信号强度值、Kep、Ve及Ktrans值差异均无统计学意义(P>0.05)。结论:应用DWI的ADC平均值和信号特点对前列腺癌的诊断具有一定价值,且ADC平均值与前列腺癌危险程度呈负相关,可以有效评估前列腺癌的危险程度。
Objective To explore the value of MRI DWl for diagnosing prostate cancer and the correlation between ADC average and prostate cancer severity so as to facilitate imaging evaluation of prostate cancer severity. Methods Totally 41 prostate cancer patients confirmed histopathologically were enrolled into an experimental group, while other 56 prostatic hyperplasia patients were involved into a control group. The patients in the two groups underwent DWl scan before the operation, and then independent t-test was used to compare the two groups on average of apparent diffusion coefficient （ADC）, signal intensity value as well as DCE-MRI parameters including interstitiumto plasma rate （Kap）, volume transfer constant （Ktrans） and fractional extra-vascular extracellular volume （Ve）. The experimental group was divided into sub-groups of low-, intermediate-and high-risk according to PSA values, Gleason scores and postoperative TNM stages, multifactor analysis of variance was used to explore the parameter differences between the sub-groups, and the correlation between the risk level and the parameters by Spearman method. Results The experimental group had the ADC average and signal intensity values with b being 800 or 50 s/mm2 were （76.02±16.24）, （106.27±28.36） and （92.89±16.17）mm2/s respectively, which were all significantly lower than those in the control group （P〈0.05）; the values of Kepv Ve and Ktrans were （0.83±0.07）min-1, （0.39±0.08）% and （0.42±0.06）min-1 respectively, which were all statistically higher than those in the control group （P〈0.05）; there was a strong negative correlation between the ADC average and risk level （r=-0.689, P=0.00）; there were significant differences between the ADC averages in low-, intermediate- and high- risk sub-groups （P〈0.05）; obvious differences were not found between the values of signal intensity values, Kepr, Ve and Ktrans （P〉0.05）. Conclusion DWI is of great value for diagnosing prostate cancer, and ADC average
作者
陈芬
骆华春
傅志超
廖绍光
程惠华
CHEN Fen;LUO Hua-chun;FU Zhi-chao;LIAO Shao-guang;CHENG Hui-hua(Department of Radiation Oncology,the 900th Hospital of Joint Logistics Support Force,Fuzhou 350025,China)
出处
《医疗卫生装备》
CAS
2018年第11期57-59,73,共4页
Chinese Medical Equipment Journal
基金
福建省自然科学基金资助项目(2018J01346)
福州总医院院内课题(2017L02)
福建医科大学启航基金资助项目(2016QH129)
关键词
前列腺癌
MRI
DWI
ADC平均值
危险程度
前列腺增生
prostate cancer
magnetic resonance imaging
diffusion weighted imaging
ADC average
risk level
prostatic hyperplasia
