浙江医学2017，Vol.39Issue(1)：7-11,后插3,6.
DCE-MRI联合DWI定量分析在前列腺癌诊断中的应用价值
Application of quantitative DCE-MRI combined with DWI in diagnosis of prostate cancer
摘要
Abstract
Objective To evaluate the application of quantitative dynamic contrast-enhanced MRI (DCE-MRI) combined with diffusion weighted imaging (DWI) in diagnosis of prostate cancer (PCa).Methods Eighty one patients with prostate diseases,including 44 patients with PCa and 37 patients with benign prostatic hyperplasia (BPH),undergoing conventional MRI,DWI and DCE-MRI examinations were enrolled in the study.The apparent diffusion coefficient (ADC) values and the quantitative permeability parameters Ktrans、Kep、Ve、Vp of the lesions were calculated and compared between PCa patients and BPH patients.The diagnosis value of each parameter was evaluated by ROC curve,and the diagnosrtic efficiency of the ADC combined with the permeability parameters was analyzed by logistic analysis.Results The Ktrans、Kep、Ve、Vp and ADC values of the malignant lesions were (2.40 ± 1.13)min-1,(1.90 ± 0.72)min-1,0.82 ± 0.24,0.31 ± 0.25 and (0.93 ± 0.43) × 10-3mm2/s,while those of the benign lesions were (1.07 ± 1.08)min-1,(1.04 ± 0.48)min-1,0.64 ± 0.37,0.43 ± 0.36 and (1.74 ± 0.38) × 10-3mm2/s,respectively.The Ktrans,Kep and Ve of PCa patients were higher than those of BPH patients (P＜0.05),while the ADC of BPH patients was higher than that of PCa patients (P＜0.05).The sensitivity of the Ktrans,Kep,Ve and ADC values was 84.1％,68.2％,79.5％,86.5％ and the specificity was 75.7％,86.5％,70.3％,84.1％,respectively (P＜0.05).There was no significant difference in Vp (P =0.211).ADC values combined with permeability parameters in the diagnosis of PCa,Kep plus ADC presented the best diagnostic efficacy when the two parameters combined (AUC =0.939).The diagnostic efficacy was not significantly improved when ADC combined with the other two parameters.Ktrans+Kep+Ve+ADC had the higher diagnostic efficiency (AUC =0.940),which was significantly higher than that of single parameter.Conclusion Quantitative DCE-MRI combined with DWI can increase the diagnostic value for PCa.The parameter KEP and ADC value can be used to improve the diagnostic efficacy,and differential diagnosis of PCa from benign hyperplasia.关键词
前列腺癌/动态对比增强磁共振成像/弥散加权成像Key words
Prostate cancer/Dynamic contrast-enhanced MRI/Diffusion weighted imaging引用本文复制引用
马向征,王世威,许茂盛,喻迎星,吕锟,庞佩佩..DCE-MRI联合DWI定量分析在前列腺癌诊断中的应用价值[J].浙江医学,2017,39(1):7-11,后插3,6.基金项目
浙江省医药卫生科技计划项目(2014KYB171) （2014KYB171）
浙江省中医药科技计划项目(2014ZB042) （2014ZB042）
