摘要
目的 3.0T MR动态增强成像 (MR DCE-MRI)在前列腺癌诊断中的应用 研究。方法 回顾性分析我院2013年5 月至2015年5月经穿刺活检病理证实的 80例前列腺疾病患者的临床资料,其 中前列腺癌50例,前列腺增生30例, 均行DCE-MRI与3.0T MR扩散加权成像 (DWI)检查,采用DCE-MRI诊断前列腺癌 与前列腺增生,并分析两者的平均达 峰时间(Tmax)、最大增强斜率(MSI)及 信号增强率(SER)。比较DCE-MRI与DWI 对前列腺癌诊断的敏感度、特异度及 准确度。结果 50例前列腺癌患者中, 32例为前列腺癌,18例为中央区癌。 前列腺癌Tmax为(69068.34±18005) ms、MSI为(216.02±43.24)、SER 为(122.05±17.34)。前列腺增生 Tmax为(83012.56±24352.19)ms、 MSI为(187.26±29.35)、SER为 (108.37±11.98)。前列腺癌Tmax早于前 列腺增生、MSI、SER较前列腺增生高, 有统计学意义(P<0.05)。DCE-MRI对前 列腺癌诊断的敏感度62.00%、特异度 90.00%及准确度82.00%;T2W1对前列腺 癌诊断的敏感度71.00%、特异度84.00% 及准确度76.00%。两者对前列腺癌诊断 的敏感度、特异度及准确度比较均无统 计学意义(P>0.05)。结论 DCE-MRI与DWI 均可用于诊断前列腺癌,在前列腺病变 中各具有特征性表现.具有较好的临床 应用效果。
Objective To study the application of 3.0T dynamic contrast-enhanced MR imaging (MR DCE-MRI) in the diagnosis of prostate cancer. Methods The clinical data of 80 patients with biopsy pathologically confirmed prostate diseases who were admitted in our hospital between May 2013 and May 2015 were analyzed retrospectively. Among them, there were 50 cases with prostate cancer and 30 cases with benign prostatic hyperplasia. All patients underwent DCE-MRI and 3.0T MR diffusion weighted imaging (DWI) examination. DCE-MRI was used to diagnose prostate cancer and benign prostatic hyperplasia. The mean time to peak (Tmax), maximum slope of increase (MSI) and signal enhancement ratio (SER) were analyzed. The sensitivity, specificity and accuracy were compared between DCE-MRI and DWI in the diagnosis of prostate cancer. Results Among the 50 cases with prostate cancer, there were 32 cases with prostate cancer and 18 cases with central cancer. Tmax, MSI and SER of prostate cancer were (69068.34±18005) ms, (216.02±43.24), (122.05±17.34) respectively while of benign prostate hyperplasia were (83012.56±24352.19) ms, (187.26±29.35) and (108.37±11.98) respectively. Tmax of prostate cancer was shorter than that of benign prostate hyperplasia while MSI and SER were than those of benign prostate hyperplasia (P<0.05). The sensitivity, specificity and accuracy of DCE-MRI in the diagnosis of prostate cancer were 62.00%, 90.00% and 82.00% respectively while of T2W1 were 71.00%, 84.00% and 76.00% respectively (P>0.05). Conclusion Both of DCE-MRI and DWI can be used for diagnosis of prostate cancer, with specific manifestations.
【关键词】3.0T MR动态增强成像;前列 腺癌;应用
【中图分类号】R737.25
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2017.05.037
前言
前列腺癌是男性生殖系统较为常见的疾病,采用MR扫描,可获得 高质量的图像[1]。目前,检查前列腺疾病最优的影像学方法为MRI,其 可多方位、多参数、多功能成像,具有很好的软组织分辨力;MRI检 测T2W1成像能较好的显示患者前列腺的解剖结构与周围组织结构[2]。 前列腺癌在T2W1表现主要为外周带内呈低信号影,但出血、前列腺炎 症、内分泌治疗后、钙化均可表现为外周带内低信号,增加了前列腺 癌的诊断困难[3]。随着3.0T MRI软硬件技术的快速发展,各种MR功能 成像亦逐渐应用于临床,如DCE-MRI、DWI等,其可对前列腺的解剖结 构、组织学特性、物质代谢等提供充分信息,现已成为诊断前列腺癌 的研究热点[4]。本研究主要探讨了3.0T MR DCE-MRI在前列腺癌诊断中 的应用,对我院经穿刺活检病理证实的80例前列腺疾病患者的临床资 料进行分析,现将结果报道如下。
中国CT和MRI杂志
第15卷, 第 5 期
2017年05月
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