中国癌症杂志 ›› 2014, Vol. 24 ›› Issue (3): 212-216.doi: 10.3969/j.issn.1007-3969.2014.03.010

• 论著 • 上一篇    下一篇

前列腺局限性病变良恶性鉴别诊断:弥散加权成像图与表观弥散系数值比较

杨雪融,刘晓航,周良平   

  1. 复旦大学附属肿瘤医院放射科,复旦大学上海医学院肿瘤学系,上海 200032
  • 出版日期:2014-03-31 发布日期:2014-04-01
  • 通信作者: 周良平 E-mail:zhoulp2003@aliyun.com

Differential diagnosis of localized prostate cancer: comparing diffusion weighted imaging with apparent diffusion coefficients

YANG Xue-rong, LIU Xiao-hang, ZHOU Liang-ping   

  1. Department of Radiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2014-03-31 Online:2014-04-01
  • Contact: ZHOU Liang-ping E-mail: zhoulp2003@aliyun.com

摘要:

背景与目的:局限性前列腺癌检出日益增多,未突破包膜的癌灶与炎性反应增生等良性病变的鉴别对早期诊断及治疗具有重要意义。本研究旨在比较3.0T磁共振弥散加权成像(diffusion weighted imagingDWI)和表观弥散系数(apparent diffusion coefficientADC)在前列腺局限性病变良恶性鉴别诊断中的价值。方法:经穿刺或手术病理证实的局限性前列腺癌患者69例,其中外周带(peripheral zonePZ)和中央腺体(central glandCG)病变分别4326例,慢性炎性反应33例和良性增生37例,测量并比较病灶的ADC(b=01 000 s/mm2)DWI图像上信噪比(signal noise ratioSNR)和半定量分级,应用受试者工作曲线评价诊断效能。结果:PZ45处癌灶、36处炎性反应;CG27处癌灶、42处增生。ADC值鉴别PZCG良恶性病变的灵敏度和特异度分别为88.9%86.1%81.5%73.8%,其诊断效能高于半定量DWI分级和SNR(P<0.05)结论:ADC值诊断前列腺局限性病变的效能优于DWI图像,可作为一项良好的鉴别诊断指标。

关键词: 前列腺癌, 弥散加权成像, 表观弥散系数

Abstract:

Background and purpose: Since the detection of localized prostate cancer is increasing, it's important to distinguish from benign lesions like prostatitis. This study aimed to compare diffusion weighted imaging with apparent diffusion coefficients in differential diagnosis of localized prostate cancer on 3.0T MR. Methods: Sixtynine cases with localized prostate cancer proved by pathology, 43 in perpheral zone (PZ) and 26 in central gland (CG), 33 with prostatitis, and 37 with benign prostatic hyperplasia (BPH) were analyzed. The signal noise ratio (SNR) and apparent diffusion coefficient (ADC) value of lesions were measured, and a semiquantitative grading of DW image was performed. The diagnostic accuracy of both methods was evaluated by ROC. Results: 45 cancer foci and 36 prostatitis lesions in PZ, 27 cancer foci and 42 BPH lesions in CG were included. The sensitivity and specificity for ADC value to distinguish cancer from begin lesions in PZ and CG were 88.9% and 86.1%81.5% and 73.8% respectively. The diagnostic accuracy of ADC value was higher than DWI semiquantitative grading and SNR (P<0.05). Conclusion: ADC value yielded a higher accuracy in differential diagnosis of localized prostate cancer on 3.0T MR, thus it’s recommended as a major index for diagnosis.

Key words: Prostate cancer, Diffusion weighted imaging, Apparent diffusion coefficient