磁共振动态对比增强直方图分析在前列腺癌鉴别诊断中的价值

发布时间：2018-03-18 22:26

本文选题：前列腺肿瘤　切入点：磁共振动态对比增强　出处：《第三军医大学学报》2017年22期 　论文类型：期刊论文

【摘要】：目的探讨磁共振动态对比增强(dynamic contrast enhanced magnetic resonance imaging,DCE-MRI)定量参数直方图分析对前列腺癌检出的应用价值。方法收集本院2016年10月至2017年6月行盆腔常规MRI、DWI和DCE-MRI扫描的患者72例,经病理证实的前列腺癌(prostate cancer,PCa)38例,前列腺增生(prostatic hyperplasia,BPH)18例,结合影像表现、实验室检查及随访观察诊断前列腺炎16例。利用第三方后处理软件(Omni Kinetic,OK),在病灶最大中心层面勾画感兴趣区,获得感兴趣区内DCE-MRI定量参数(Ktrans、Kep和Ve)的平均值及各百分位数值(5%、10%、25%、50%、75%、90%和95%),分别比较外周带PCa与前列腺炎、中央腺体PCa与BPH各参数值的差异,并分析诊断效能。结果外周带PCa组Ktrans平均值及各百分位数值均大于前列腺炎(平均值及50%、75%、90%和95%百分位数值P0.05)。PCa组Kep平均值及各百分位数值均大于前列腺炎(P0.05)。外周带PCa组Ve平均值及各百分位数值小于或等于前列腺炎(5%、10%、25%和50%百分位数值P0.05)。中央腺体PCa与BPH渗透参数Ktrans、Kep、Ve的平均值及各百分位数值差异均无统计学意义(P0.05)。外周带PCa组Ktrans和Kep高百分位数AUC大于平均值,低百分位数AUC最小,90%Kep诊断效能最大(AUC为0.932,敏感度78.3%,特异度92.9%);外周带PCa组Ve百分位数不具有诊断效能。结论基于DCE-MRI的直方图分析在外周带PCa与前列腺炎鉴别诊断中具有临床价值,Ktrans、Kep高百分位数诊断效能优于平均值和低百分位数。
[Abstract]:Objective to evaluate the value of dynamic contrast enhanced magnetic resonance imagingMr histogram analysis in the detection of prostate cancer. Methods from October 2016 to June 2017, 72 patients with conventional contrast magnetic resonance imaging DWI and DCE-MRI were collected from our hospital. There were 38 cases of prostate cancer, 18 cases of prostatic hyperplasia, and 18 cases of pathologically proved prostate cancer. Sixteen cases of prostatitis were diagnosed by laboratory examination and follow up observation combined with the imaging findings. The third party post-processing software Omni Kineticus OKA was used to draw the area of interest at the largest central level of the lesion. The average value and the percentile value of DCE-MRI quantitative parameters (KTranskep and Veg) in the region of interest were obtained. The difference of parameters between peripheral PCa and prostatitis, central glandular PCa and BPH was compared, and the values of five percentiles were 5% and 50%, 75%, 90% and 95%, respectively, in the peripheral zone and prostatitis, central gland PCa and BPH, respectively. Results the mean value and percentile value of Ktrans in peripheral PCa group were higher than that in prostatitis group (mean value and 95% percentile value P0.05U 路PCA group were higher than that in prostatitis group P0.050.The peripheral zone was larger than that in the peripheral zone. The mean value of ve and percentile of PCa group were less than or equal to that of prostatitis group (25%) and the value of 50% percentile (P0.05). There was no significant difference between the mean value of PCa of central gland and that of BPH osmotic parameter Ktranskepus V and the value of percentile of BPH. There was no significant difference between the mean value of PCa and the value of each percentile of BPH in the peripheral PCa group (P 0.05). And the Kep high percentile AUC is greater than the average, The diagnostic efficacy of low percentile AUC was 0.932, the sensitivity was 78.3, the specificity was 92.99.The ve percentile of peripheral PCa group was not effective. Conclusion the histogram analysis based on DCE-MRI is useful in the differential diagnosis of peripheral PCa and prostatitis. The high percentile value of KtransP Kep is superior to the average and low percentile.
【作者单位】：重庆医科大学附属第二医院放射科;
【基金】：国家自然科学基金青年科学基金项目(81401382) 重庆市卫计委医学科研计划项目(2016MSXM024,2017MSXM035)~~
【分类号】：R445.2;R737.25

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