动态增强磁共振成像联合弥散加权成像对前列腺癌的诊断效能

Diagnostic efficacy of dynamic contrast-enhanced magnetic resonance imaging combined with diffusion-weighted imaging for prostate cancer

  • 摘要:
    目的 分析动态增强磁共振成像(DCE-MRI)联合弥散加权成像(DWI)诊断前列腺癌(PCa)的效能。
    方法 选取94例前列腺疾病患者为研究对象,并分为PCa组(n=41)、前列腺增生(BPH)组(n=53)。比较2组患者一般资料。分析DCE-MRI、DWI检查参数诊断PCa的效能及其与血清前列腺特异性抗原(PSA)的相关性。
    结果 2组总前列腺特异性抗原(tPSA)、游离前列腺特异性抗原(fPSA)/tPSA、前列腺体积(V)、前列腺特异抗原密度(PSAD)、血浆容积分数(Vp)、反流速率常数(Kep)、容积转运常数(Ktrans)、血管外细胞外间隙容积分数(Ve)、表观扩散系数(ADC)比较, 差异有统计学意义(P < 0.05)。DCE-MRI与DWI检查参数联合预测PCa的曲线下面积为0.924, 大于各指标单独预测或DCE-MRI检查参数联合预测。KtransKepVe与tPSA呈正相关,与fPSA/tPSA呈负相关, Vp、ADC与tPSA呈负相关,与fPSA/tPSA呈正相关(P < 0.05)。
    结论 DCE-MRI联合DWI对PCa的诊断价值较高,且KtransKepVeVp、ADC与tPSA、fPSA/tPSA具有一定相关性。

     

    Abstract:
    Objective To analyze the diagnostic efficacy of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with diffusion-weighted imaging (DWI) in prostate cancer (PCa).
    Methods A total of 94 patients with prostate diseases were selected as study subjects, and divided into PCa group (n=41) and benign prostatic hyperplasia (BPH) group (n=53). The general information of the two groups was compared. The diagnostic efficacy of DCE-MRI and DWI examination parameters in PCa and their correlation with serum prostate-specific antigen (PSA) were analyzed.
    Results There were statistically significant differences in total prostate-specific antigen (tPSA), free prostate-specific antigen (fPSA)/tPSA, prostate volume (V), prostate-specific antigen density (PSAD), plasma volume fraction (Vp), reflux rate constant (Kep), volume transfer constant (Ktrans), extracellular extravascular volume fraction (Ve) and apparent diffusion coefficient (ADC) between the two groups (P < 0.05). The area under the curve for the combined prediction of PCa using DCE-MRI and DWI examination parameters was 0.924, which was greater than that for individual predictors or the combination of DCE-MRI examination parameters. Ktrans, Kep and Ve were positively correlated with tPSA and negatively correlated with fPSA/tPSA, while Vp and ADC were negatively correlated with tPSA and positively correlated with fPSA/tPSA (P < 0.05).
    Conclusion The combination of DCE-MRI and DWI has high diagnostic value for predicting PCa, and Ktrans, Kep, Ve, Vp and ADC have certain correlations with tPSA and fPSA/tPSA.

     

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