摘要
目的评估体素内不相干运动成像(IVIM-DWI)及动态增强MRI(DCE-MRI)在前列腺癌诊断及分级中的应用价值。资料与方法对符合纳入标准的24例前列腺癌患者及21例良性前列腺增生患者行IVIM-DWI及DCE-MRI检查,经后处理得到IVIM-DWI参数真实的扩散系数(D)、伪扩散系数(D*)、灌注分数(f)和DCE-MRI参数容量转移常数(K^(trans))、速率常数(K_(ep))、血管外细胞外间隙容积分数(V_e)、血管空间容积分数(V_p)。比较各参数在前列腺癌及前列腺增生中的差异,并通过受试者工作特性曲线评估其诊断效能。根据前列腺癌的Gleason评分结果分组,比较不同组间各参数的差异。结果前列腺癌组K^(trans)、K_(ep)、V_p、D*值较良性前列腺增生组增大,V_e、D、f值较良性前列腺增生组减小,差异有统计学意义(P<0.05)。各参数的诊断效能以f值、D值较高。前列腺癌不同GS评分组间D、D*、f、K_(ep)值差异有统计学意义(P<0.05),随Gleason评分升高,D值减小、D*值增大,f值、K_(ep)值先增大后减小。结论 IVIM-DWI及DCE-MRI各参数可有效鉴别前列腺癌与前列腺增生,其中IVIM-DWI更具优势。IVIM-DWI参数中D值减小、D*值增大及f值先增大后减小可提示高级别前列腺癌。
Purpose To evaluate the application value of intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in diagnosis and classification of prostate cancer.Materials and Methods Twenty-four patients with prostate cancer and 21 patients with benign prostatic hyperplasia who met the inclusion criteria were examined by IVIM-DWI and DCE-MRI.After treatment,true diffusion coefficient(D)of IVIM-DWI parameters,pseudo-diffusion coefficient(D*),perfusion fraction(f),DCE-MRI parameters volume transfer constant(Ktrans),speed constant(Kep),extravascular extracellular spatial volume fraction(Ve)and vascular spatial volume fraction(Vp)were obtained.The differences between parameters of prostate cancer and that of benign prostatic hyperplasia were compared,and their diagnostic efficiency was assessed using receiver operating characteristic curves.Patients were divided into groups as Gleason score results of prostate cancer,and the differences between parameters of different groups were compared.Results The values of Ktrans,Kep,Vp and D*in prostate cancer group were higher than those in the benign prostatic hyperplasia group,and the values of Ve,D and f were lower than those in the benign prostatic hyperplasia group,the difference of which was statistically significant(P<0.05).The diagnostic efficiency of parameters f and D was higher among other parameters.There was statistical significance concerning the difference in D,D*,f and Kep values between different GS score groups of prostate cancer(P<0.05).With the increase of Gleason score,D value decreased,D*value increased,and f and Kep values firstly increased and then decreased.Conclusion The parameters of IVIM-DWI and DCE-MRI can effectively identify prostate cancer and benign prostatic hyperplasia,with IVIM-DWI being more efficient.The decrease of D value,increase of D*,and first increase and later decrease of f value in IVIM-DWI parameters may indicate high-grade prostate cancer.
作者
徐曦
张冬
黄家喜
马孟杰
罗良平
XU Xi;ZHANG Dong;HUANG Jiaxi;MA Mengjie;LUO Liangping(Department of Medical Imaging Center,the First Affiliated Hospital of Jinan University,Guangzhou 510632,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2018年第10期772-776,780,共6页
Chinese Journal of Medical Imaging
基金
粤港联合创新项目(2016A050503032)
