摘要
目的 观察MRI-DWI及ADC诊断前列腺良恶性病变的价值。方法 选取2018年1月至2021年12月本院收治的80例疑似PCa患者为研究对象。穿刺前行MRI-DWI检查,记录图像特征,以病理结果为“金标准”,采用ROC曲线参数分析法探讨表观扩散系数(ADC)值对PCa的诊断价值,曲线下面积(AUC)表示预测的准确度。结果 本组80例患者经病理检查证实,有36例(45%)为恶性病变,均为PCa,其余44例(55%)为前列腺良性增生。MRI图像显示,PCa患者的T2WI可见病灶,DWI常表现为稍高信号,且ADC值较小,动态增强曲线呈流出型;而前列腺良性增生患者的DWI信号比PCa患者低,且ADC值稍降低,增强后强化程度低于正常前列腺组织。DWI下,PCa患者的ADC值为(0.81±0.21)mm^(2)/s,明显低于前列腺增生患者的(1.33±0.39)mm^(2)/s(P<0.05)。以ADC值作为检验变量,以病理诊断作为状态变量(1=PCa,0=前列腺增生),得出以ADC值诊断PCa的AUC为0.849,以ADC值=1.13 mm^(2)/s为界点值诊断PC的敏感性、特异性分别为97.22%、70.45%。结论 前列腺良恶性病变可通过MRI-DWI技术手段进行诊断与鉴别,ADC值用于前列腺良恶性病变的临床诊断具有较高的价值。
Objective To observe the diagnostic value of magnetic resonance imaging-diffusion weighted imaging(MRI-DWI)and apparent diffusion coefficient(ADC)for benign and malignant prostate lesions.Methods A total of 80 patients with suspected PCa admitted to the hospital were enrolled as the research objects between January 2018 and December 2021.All underwent MRI-DWI examination before puncture to record characteristics of images.Taking pathological results as the golden standard,the diagnostic value of ADC for PCa was explored by receiver operating characteristic(ROC)curves,and the predictive accuracy was represented by area under the curve(AUC).Results Of the 80 patients,it was confirmed by pathological examination that there were 36 cases(45%)with malignant lesions(PCa)and 44 cases(55%)with benign prostatic hyperplasia.MRI images for PCa patients showed that there were lesions on T2WI.DWI showed that there were slightly high signals,low ADC value and flow-out dynamic enhancement curves.Compared with PCa patients,MRI images for patients with benign prostatic hyperplasia showed that there was no significant high signal in DWI,slightly reduced ADC signals.The enhancement degree was lower than that in normal prostate tissues.In DWI,ADC value in PCa patients was significantly lower than that in patients with benign prostatic hyperplasia[(0.81±0.21)mm^(2)/s vs(1.33±0.39)mm^(2)/s](P<0.05).AUC of ADC value in the diagnosis of PCa was 0.849.The sensitivity and specificity of ADC(cut-off value=1.13 mm^(2)/s)in the diagnosis of PC were 97.22%and 70.45%,respectively.Conclusion MRI-DWI can be applied as one of the technical means in the differential diagnosis of benign and malignant prostate lesions.ADC value has high clinical diagnostic value for benign and malignant prostate lesions.
作者
柏凡
丁聪
柏根基
BAI Fan;DING Cong;BAI Gen-ji(Department of Medical Imaging,the First People's Hospital of Huai'an City,Huai'an 223300,Jiangsu Province,China)
出处
《中国CT和MRI杂志》
2023年第4期148-149,共2页
Chinese Journal of CT and MRI
基金
淮安市市级科技计划专项资金项目(HAS2015014)。
关键词
前列腺癌
磁共振弥散成像
表观扩散系数
受试者工作特征曲线
Prostate Cancer
Magnetic Resonance Imaging
Apparent Diffusion Coefficient
Receiver Operating Characteristic Curve
