3-T MR扩散加权成像诊断前列腺癌最优b值探究

发布时间：2018-05-06 18:27

本文选题：前列腺肿瘤 + 鉴别诊断　；参考：《第二军医大学学报》2015年04期

【摘要】：目的以磁共振超声融合靶向穿刺联合系统穿刺病理结果为金标准,探究3-T MR扩散加权成像(DWI)诊断前列腺癌的最优b值。方法前瞻性招募临床拟诊为前列腺癌的患者43例,于穿刺前行包括常规T2WI及10个b值(0、50、100、150、200、500、800、1 000、1 500、2 000s/mm2)DWI在内的MR检查。采用DWI联合T2WI对病灶进行分析判断,根据MR诊断结果选择穿刺方式。MR提示有可疑病灶者行靶向穿刺联合系统穿刺,未提示可疑灶者行单纯系统穿刺。选择病理确诊为前列腺癌的患者,测量不同b值病灶及正常组织的DWI信号强度。采用Wilcoxon Signed Ranks非参数配对检验分析不同b值病灶和正常组织信号强度差异是否具有统计学意义,采用受试者工作特征(ROC)曲线计算各b值诊断曲线下面积(AUC)、敏感性和特异性。结果入组病例共43例,22例确诊为前列腺癌,16例为良性前列腺增生,5例为前列腺炎。在确诊为前列腺癌的22例中,16例病灶在b值为1 500s/mm2 DWI上显示较为清晰,6例病灶在b值为2 000s/mm2 DWI上显示较为清晰。Wilcoxon Signed Ranks结果显示当b值为500s/mm2时病灶和正常组织信号强度差异无统计学意义(P=0.236),在其他b值图像上病灶和正常组织信号强度差异均有统计学意义(P0.000 1)。ROC曲线分析提示b值为1 500s/mm2时AUC最大(0.933)。当诊断的信号强度cut-off值为49.2时,诊断的敏感性和特异性分别为0.909和0.909。结论3-T MR DWI在b值为1 500s/mm2时具有最佳显示病灶能力,在b值为500s/mm2时无法区分诊断前列腺癌与正常组织。
[Abstract]:Objective to explore the optimal b value of 3 T Mr diffusion weighted imaging (DWI) for diagnosis of prostate cancer. Methods 43 patients with prostate cancer were recruited prospectively, including routine T2WI and 10 b values before puncture, including 1 000 ~ 1 000 ~ 1 000 ~ 1 000 ~ 1 000 ~ 1 000 ~ 1 000 ~ 1 000 ~ 1 000 000s/mm2)DWI before puncture, including 10 b values of 50, 100, 150, 200, 500, 800, 1, 000, 1, 500, 2 000s/mm2)DWI. DWI combined with T2WI was used to analyze and judge the lesions. According to the results of Mr diagnosis, the method of puncture was chosen. The DWI signal intensity of different b lesions and normal tissues were measured in patients with pathologically diagnosed prostate cancer. The Wilcoxon Signed Ranks nonparametric pairing test was used to analyze whether the difference of signal intensity between different b value lesions and normal tissues was statistically significant. The area under each b value diagnostic curve was calculated by using the operating characteristics of the subjects. The sensitivity and specificity of each b value diagnosis curve were calculated. Results there were 43 cases of benign prostatic hyperplasia and 5 cases of prostatitis. In 22 cases of prostate cancer, 16 lesions were clearly displayed on b value 1 500s/mm2 DWI. Wilcoxon Signed Ranks showed clear lesions on b value 2 000s/mm2 DWI. Wilcoxon Signed Ranks results showed that lesions and normal tissue signals were detected when b value was 500s/mm2. There was no significant difference in intensity between lesion and normal tissue on other b value images. The analysis of P0. 000 1).ROC curve showed that the maximum value of AUC was 0. 933 when b was 1 500s/mm2. The sensitivity and specificity of the diagnosis were 0.909 and 0.909, respectively, when the cut-off value of the diagnostic signal was 49.2. Conclusion 3-T Mr DWI has the best ability to display lesions when b value is 1 500s/mm2, and can not distinguish prostate cancer from normal tissue when b value is 500s/mm2.
【作者单位】：第二军医大学长海医院影像医学科;第二军医大学长海医院泌尿外科;第二军医大学长海医院病理科;
【基金】：上海市卫生和计划生育委员会项目(M20140149)~~
【分类号】：R737.25;R445.2

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