3.0TMR DTI联合DCE-MRI对外周带前列腺癌的诊断价值研究

发布时间：2018-07-01 21:45

本文选题：磁共振成像 + 扩散张量成像　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：第一部分3.0T MR DTI在外周带前列腺癌诊断中的应用价值目的探讨扩散张量成像(DTI)对外周带前列腺癌(PCa)诊断中的应用价值。方法回顾性分析经病理证实的65例前列腺疾患,其中25例外周带PCa患者(恶性组),40例良性前列腺增生(BPH)和/或慢性前列腺炎(CP)患者(良性组),所有患者于穿刺前均行常规MRI、DWI及DTI扫描。选择ROI法测量病灶ADC值及FA值。通过ROC的曲线下面积(AUC)值比较ADC值、FA值及两者联合对外周带PCa的诊断效能,并初步得出ADC值、FA值诊断外周带PCa的阈值。结果前列腺外周带癌区与非癌区ADC值和FA值分别为(0.89±0.19)×10~(-3)mm~2/s,0.25±0.05和(1.46±0.23)×10~(-3) mm~2/s,0.17±0.04,两者差异均有统计学意义(t值分别为10.414和-7.789,P值均0.05)。ADC阈值为1.135×10~(-3) mm~2/s,诊断外周带PCa敏感度、特异度分别为96.0%和95.0%;FA阈值为0.196,敏感度、特异度分别为96.0%和85.0%。ROC曲线上,ADC值、FA值及两者联合的AUC分别为0.974,0.907和0.990,95%置信区间分别为0.900~0.998,0.809~0.965和0.926~1.000。结论DTI评价参数ADC、FA值均可为外周带PCa的诊断及鉴别诊断提供重要的信息,两者结合对外周带PCa的诊断效能较单独使用任意一参数高。第二部分3.0 MR DTI联合DCE-MRI对外周带前列腺癌的诊断价值目的探讨DTI结合DCE-MRI对外周带PCa的诊断价值。方法参照第2版前列腺影像报告和数据系统(PI-RADSv2)中DCE-MRI应用分类标准,观察分类所有纳入病例的DCE-MRI影像资料。利用ADC、FA值诊断外周带PCa的诊断阈值,对本文纳入的65例患者资料进行转化分类。ADC值"f1.135×10~(-3)mm~2/s、FA值0.196记为阳性,反之记为阴性;ADC值、FA值分类与DCE-MRI分类联合:两两联合,当n(阳性数)"g1时,记为阳性;三者联合,当n(阳性数)"g2时,记为阳性,反之记为阴性。通过ROC的方法,运用AUC比较ADC、FA、DCE-MRI分类结果及联合方案对外周带PCa的诊断效能。结果ADC、FA、DCE-MRI及ADC+DCE-MRI、FA+DCE-MRI、ADC+FA+DCE-MRI联合诊断外周带PCa的敏感度、特异度分别为96.0、95.0,96.0、85.0,72.0、77.5,96.0、72.5,96.0、62.5,92.0、100.0。AUC分别为0.955、0.905、0.747、0.842、0.793和0.960,95%置信区间分别为0.873~0.991,0.806~0.964,0.624~0.847,0.731~0.921,0.674~0.883和0.880~0.993。结论ADC+DCE-MRI较FA+DCE-MRI对外周带PCa的诊断效能高,ADC+FA+DCE-MRI分类对外周带PCa的诊断效能最高。
[Abstract]:The value of 3.0T Mr DTI in the diagnosis of peripheral prostate cancer objective to investigate the value of diffusion Zhang Liang imaging (DTI) in the diagnosis of peripheral prostate cancer (PCA). Methods 65 cases of prostate diseases confirmed by pathology were retrospectively analyzed. Twenty-five patients with peripheral PCA (malignant group) had benign prostatic hyperplasia (BPH) and / or chronic prostatitis (CP) (benign group). All patients underwent conventional MRII-DWI and DTI before puncture. ADC and FA values were measured by ROI method. The area under curve (AUC) value of ROC was used to compare the value of ADC and the diagnostic efficiency of peripheral zone PCA, and the threshold value of ADC value and FA value for diagnosing peripheral zone PCA was preliminarily obtained. Results the ADC values and FA values in the peripheral and non-cancerous areas of the prostate were (0.89 卤0.19) 脳 10 ~ (-3) mm ~ (-3) mm ~ (-2) and (1.46 卤0.23) 脳 10 ~ (-3) mm ~ (-3) mm ~ (-2) 路s ~ (2) and (1.46 卤0.23) 脳 10 ~ (-3) mm ~ (-3) mm ~ (2) P, respectively. The ADC threshold was 1.135 脳 10 ~ (-3) mm ~ (-2) / s, and the difference was statistically significant (t = 10.414 and -7.789 P = 1.135 脳 10 ~ (-3) mm ~ (-2) / s, respectively). The specificity was 96.0% and 95.0%, the threshold value of FA was 0.196, the sensitivity, the specificity were 96.0% and 85.0%, respectively, and the AUC of the ADC value and the combination of the two were 0.9000.9980.8090.965 and 0.9261.000, respectively, and the AUC of the combination were 0.9000.9980.8090.965 and 0.9261.000, respectively. Conclusion the ADCF value of DTI evaluation parameters can provide important information for the diagnosis and differential diagnosis of peripheral PCA. The diagnostic efficacy of the two parameters combined with peripheral zone PCA is higher than that of any other parameter alone. Part 2: diagnostic value of 3. 0 Mr DTI combined with DCE-MRI in peripheral prostate cancer objective to explore the diagnostic value of DTI combined with DCE-MRI in peripheral zone PCA. Methods according to the DCE-MRI classification standard in the second edition of prostate imaging report and data system (PI-RADSv2), the DCE-MRI image data of all the patients included in the classification were observed. Using ADCFFA value to diagnose the diagnostic threshold of peripheral PCA, the data of 65 patients included in this paper were classified as positive. The ADC value "f 1.135 脳 10 ~ (-3) mm ~ (-3) was positive, whereas the negative ADC value and DCE-MRI classification were combined with DCE-MRI classification: two combinations, when n (positive number)" g _ 1. When n (positive number) "g 2, it is positive and negative. By means of ROC, AUC was used to compare the classification results of DCE-MRI and the diagnostic efficacy of the combined regimen. Results the sensitivity and specificity of ADC DCE-MRI and ADC DCE-MRIFA DCE-MRI in the diagnosis of peripheral zone PCA were 96.0 ~ 95.095.09.00.85.0 ~ 77.59.596.0 ~ 72.596.56.00.62.56.52.52.0100.AUC were 0.955 / 0.9050.9070.7470.8420.793 and 0.96095% confidence intervals were 0.8730.9930.9930.9930.9940.8060.9640.9640.7310.921 / 0, 0.6740.883 respectively. Conclusion ADC DCE-MRI is more effective than FA DCE-MRI in the diagnosis of peripheral PCA.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R737.25

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