灌注加权成像定量参数及磁共振波谱成像诊断前列腺癌的价值

发布时间：2018-03-11 00:21

本文选题：灌注加权成像　切入点：动态对比增强　出处：《遵义医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对前列腺良恶性疾病患者行常规磁共振成像(magnetic resonance imaging,MRI)、动态对比增强(dynamic contrast enhanced,DCE)及磁共振波谱成像(magnetic resonance spectroscopy,MRS)扫描,探讨DCE灌注参数、MRS在前列腺癌(prostate cancer,PCa)诊断中的应用价值以及前列腺特异性抗原之比与DCE灌注参数、MRS的相关性。方法:收集经病理或诊断性治疗证实的非PCa患者25例(其中单纯良性前列腺增生患者17例,良性前列腺增生合并炎症患者8例)、病理或随访证实的PCa患者16例、正常健康志愿者对照组20例,均行常规前列腺MRI、DCE、MRS检查。所有患者及健康志愿者扫描前均检测血清总前列腺特异性抗原(total prostate specific antigen,T-PSA)、血清游离前列腺特异性抗原(Free prostate specific antigen,F-PSA)。结果:1.PCa组、非PCa组、正常对照组三组的T-PSA值分别为(52.60±103.26ng/m L)、(15.09±9.75ng/m L)、(2.46±0.68ng/m L);各组的F-PSA值分别为(4.56±3.48ng/m L)、(2.08±1.15ng/m L)、(0.59±0.16ng/m L);各组的F/T-PSA值分别为(0.18±0.08)、(0.15±0.05)、(0.24±0.04);2.各组的K~trans值分别为(0.19±0.07min-1)、(0.11±0.03min-1)、(0.06±0.02min-1),组间差异及两两比较均有统计学意义(P0.05);3.各组的Kep值分别为(1.06±0.13min-1)、(0.73±0.19min-1)、(0.63±0.11min-1),组间差异及两两比较均有统计学意义(P0.05);4.各组的Ve值分别为(0.17±0.07)、(0.11±0.04)、(0.10±0.03),组间差异有统计学意义(P0.05),两两比较,PCa组和各组间差异均有统计学意义(P0.05),而非PCa组与正常对照组间差异无统计学意义(P0.05);5.K~trans、Kep、Ve诊断PCa的最佳阈值分别为0.14min-1、0.925min-1、0.145。6.PCa组、非PCa组、正常对照组三组的(Cho+Cr)/Cit值分别为(5.17±3.68)、(0.70±0.43)、(0.37±0.47),组间差异及两两比较均有统计学意义(P0.05)。7.PCa组与非PCa组的F/T-PSA与K~trans、Kep、Ve、(Cho+Cr)/Cit值之间的相关系数r分别为0.038(P0.05)、0.05(P0.05)、-0.013(P0.05)、0.338(P0.05)。结论:1.DCE、MRS均对PCa有重要的诊断及鉴别诊断价值;2.DCE灌注参数(K~trans、Kep、Ve)中,K~trans、Kep的诊断效能最高,K~trans的特异度较高,而Kep的敏感度较高,三者诊断前列腺癌的最佳阈值分别为0.14min-1、0.925min-1、0.145;3.F/T-PSA与(Cho+Cr)/Cit值之间存在较弱的正相关关系,与DCE灌注参数之间均无明显相关性。
[Abstract]:Objective: to study the clinical features of benign and malignant prostatic diseases (BPH) by routine magnetic resonance imaging (MRI), dynamic contrast enhanced resonance (DCE) and magnetic resonance spectrum imaging (MRS). To investigate the value of DCE perfusion parameter Mrs in the diagnosis of prostate cancer in prostate cancer and the correlation between the ratio of prostate specific antigen and DCE perfusion parameter Mrs. Methods: 25 cases of non-PCa patients confirmed by pathological or diagnostic treatment were collected. (among them, 17 patients with simple benign prostatic hyperplasia, There were 8 cases of benign prostatic hyperplasia complicated with inflammation, 16 cases of PCa confirmed by pathology or follow-up, and 20 cases of normal control group. All patients and healthy volunteers were examined for total prostate specific antigenase T-PSAA and free prostate specific antigen-F-PSAA before scanning. Results the results showed that the serum total prostate specific antigenase T-PSAA and free prostate specific antigen-PSAA were detected in all patients and healthy volunteers before scanning. Results the results showed that the serum total prostate specific antigen-PSAA and free prostate specific antigen-PSAA were detected in all patients and healthy volunteers before scanning. Results: 1. The T-PSA values of the normal control group were 52.60 卤103.26ngmL / L = 15.09 卤9.75ngmL / L = 2.46 卤0.68ng / mL, respectively, and the F-PSA values of each group were 4.56 卤3.48ngm / L / L = 4.56 卤3.48ngm / L = 2.08 卤1.15ngmL / L = 0.59 卤0.16ngm / L, respectively. The F-PSA value of each group was 0.18 卤0.08ngmL / L = 0.24 卤0.04ngL / L respectively. The K#en0# of each group was 0.19 卤0.07min-1n-1 + 0.03min-1 卤0.06 卤0.02min-1 respectively, and the difference between the two groups was statistically significant (P < 0.05). The difference between the two groups was statistically significant (P 0.05). The value of ve in each group was 0.17 卤0.07 卤0.04 卤0.010 卤0.03, there was significant difference between the two groups (P 0.05), and the difference between the two groups was statistically significant, while the difference between the two groups was significant (P 0.05), while that in the non-PCA group was significantly higher than that in the normal control group (P < 0.05), while that in the non-PCA group was significantly higher than that in the normal control group (P < 0.05), and the difference between the two groups was statistically significant (P < 0.01), while that in the non-PCA group was significantly higher than that in the normal control group (P < 0.05). There was no significant difference between the two groups. The optimal threshold for the diagnosis of PCa was 0.14min-1ng 0.925min-1 + 0.145.6.PCa, respectively. Non PCa group, The values of Cho Cr)/Cit in the normal control group were 5.17 卤3.68, 0.70 卤0.43, 0.37 卤0.47, respectively. There were significant differences between the two groups (P0.050.7.The correlation coefficient r between the FT-PSA and the Cr)/Cit value of the PCa group and the non-#en1# group were 0.038 卤3.68, P 0.05- 0.013, P 0.0338P0.05and 0.338P0.05respectively). Conclusion\\\;\\\%\\%\\%\%\%\%\%\%\%\%\%\%\%\%\% of PCa? The diagnostic value 2. The diagnostic efficacy of KTX Kep was higher than that of Ktrans in DCE perfusion parameters. 2. The specificity of Ktranstrans Kep was higher in DCE perfusion parameters (P < 0.05), and the specificity of KtransKep was higher than that of KtransKep. However, the sensitivity of Kep was higher, and the best threshold for diagnosis of prostate cancer was 0.14min-1n 0.925min-1U 0.145min -0.145t. There was a weak positive correlation between T-PSA and DCE Cr)/Cit, but there was no significant correlation between DCE perfusion parameters and T-PSA.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R737.25

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