磁共振DCE及DTI对前列腺中央区癌诊断价值的初步研究

发布时间：2018-03-15 21:53

  本文选题：前列腺癌　切入点：动态增强　出处：《石河子大学》2017年硕士论文　论文类型：学位论文

【摘要】：第一部分磁共振动态增强与扩散张量成像对前列腺中央区良恶性结节的诊断价值目的:探讨磁共振动态增强、扩散张量成像及二者联合对前列腺中央区良恶性结节的鉴别诊断价值。方法:回顾性搜集60例前列腺中央区有结节样异常信号的患者,均行磁共振T2WI、DTI及DCE扫描。经前列腺穿刺活检病理学证实:89例中央区结节中38枚为前列腺癌(PCa),51枚为良性前列腺增生(BPH),测量结节的ADC值、FA值、峰值时间(Tmax)、最大信号强度(SImax%)、强化率(R),描述SI-T曲线,比较各参数在PCa与BPH之间的差异,并进行ROC曲线分析。结果:PCa组与BPH组的ADC值、FA值、Tmax值、R值均具有统计学差异(P0.05),Slmax%组间差异无统计学意义(P0.05);PCa的SI-T曲线类型以速升下降型为主,BPH曲线类型以平台型为主。DCE、DTI及二者联合诊断的ROC曲线下面积(AUC)分别是0.87(95%CI0.751-0.942),0.85(95%CI 0.734-0.933),0.94(95%CI 0.837-0.983)。结论:DTI诊断前列腺中央区良恶性结节的准确性高于DCE,两者联合诊断效果更好。第二部分探讨DTI定量参数与前列腺中央区恶性结节Gleason评分的相关性目的:探讨磁共振弥散张量成像技术定量参数ADC值、FA值与前列腺中央区癌Gleason评分的相关性,评价DTI在中央腺前列腺癌Gleason分级中的诊断价值。方法:回顾性搜集经穿刺活检证实的38枚前列腺中央区恶性结节,所有患者均行磁共振DTI扫描,测量结节的ADC值及FA值,根据病理结果将中央腺前列腺癌分为Gleason评分"f6分,Gleason评分为=7分,Gleason评分"g8分,三组,对三组数据进行单因素方差分析(one-way ANOVA)。采用Pearson相关分析检验前列腺癌ADC值、FA值与Gleason评分的相关性。结果:三组前列腺癌区平均ADC值分别为(1.373±0.308)×10~(-3)mm~2/s、(1.002±0.20 9)×10~(-3)mm~2/s和(0.746±0.195)×10~(-3)mm~2/s,FA值分别0.375±0.281、0.301±0.231和0.196±0.231;三组ADC值、FA值组间差异均具有统计学意义(P0.05);前列腺癌灶ADC值、FA值与Gleason评分之间均呈负相关(ADC值r=-0.760,P0.05;FA值r=-0.687,P0.05),Gleason评分越高,ADC值、FA值越小。结论:前列腺中央区癌灶ADC值、FA值与Gleason评分呈负相关;DTI有助于中央腺前列腺癌临床危险度的分级判定。
[Abstract]:The first part of the diagnostic value of dynamic enhanced magnetic resonance imaging and diffusion tensor to central to prostate benign and malignant nodules: To investigate the dynamic enhanced MRI, diffusion tensor imaging and the combination of the two central prostate benign and malignant nodules differential diagnosis. Methods: retrospectively collected 60 cases of prostatic central nodular abnormal signals were received magnetic resonance T2WI, DTI and DCE scanning. By pathological biopsy of the prostate biopsy: 89 cases of central nodules in 38 for prostate cancer (PCa), 51 cases of benign prostatic hyperplasia (BPH), measuring the nodule ADC value, FA value, time to peak (Tmax), maximum intensity (SImax%), strengthening rate (R), description of SI-T curve, the difference of each parameter between PCa and BPH, and the ROC curve was analyzed. Results: PCa group and BPH group, ADC value, FA value, Tmax value, R values were statistically significant differences between the groups (P0.05), Slmax% system Statistically significant (P0.05); SI-T curve type PCa to speed up drop type, BPH type platform type.DCE curve, ROC curve area DTI and the two combined diagnosis under (AUC) were 0.87 (95%CI0.751-0.942), 0.85 (95%CI 0.734-0.933), 0.94 (95%CI 0.837-0.983). Conclusion: the accuracy of DTI diagnosis of benign and malignant prostate central nodules than DCE, combined with better diagnosis effect. The second part discusses the objective relationship between DTI quantitative parameters and Gleason score of prostate central malignant nodules: To explore the magnetic resonance diffusion tensor imaging quantitative parameters ADC value, correlation score and Gleason central prostate cancer FA value to evaluate the diagnostic value of DTI in the central gland Gleason grading of prostate cancer. Methods: retrospectively collected by biopsy confirmed 38 central prostate malignant nodules, all patients underwent magnetic resonance DTI scanning, measuring the nodule AD C鍊煎強FA鍊，

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