1.5T磁共振弥散加权成像与表观弥散系数在局限性前列腺癌与慢性炎性反应和良性增生鉴别诊断中的价值

摘要

Objective:To compare and analyze the value of diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) of 1.5T magnetic resonance (MR) in differential diagnosis for localized prostate cancer, chronic inflammatory response and benign hyperplasia.Methods: 80 patients with localized prostate cancer were enrolled in the research. The signal to noise ratio (SNR) of DWI, ADC value and semi-quantitative classification of DWI on lesions were measured, and the diagnostic efficiencies of them were compared by using ROC curve.Results: In the 80 patients with localized prostate cancer patients, there were 52 malignant lesions and 43 benign lesions in peripheral band, and there were 31 malignant lesions and 46 benign lesions in central gland. The ADC values of prostate cancer in peripheral band and central gland were 0.91±0.12 and 0.86±0.15, respectively, and they were significantly lower than that of normal tissue (1.68±0.23 and 1.28±0.31) and benign lesions (1.24±0.21 and 1.12±0.16). The semi-quantitative classifications of DWI for benign lesions were significantly higher than that for malignant lesions in peripheral band and central gland, respectively (x2=20.88,x2=12.14;P<0.05). For the diagnostic efficiency of ADC, the sensitivities of benign and malignant lesions in peripheral band and malignant gland were 91.3% and 79.1%, respectively, and the specificities of them were 89.6% and 70.2%. And they was significant higher than the corresponding sensitivities (71.2% and 51.3%)and specificities (78.4% and 65.8%) of DWI imaging.Conclusion: Both of DWI and ADC of 1.5T magnetic resonance are the important indexes in differential diagnosis for prostate cancer, chronic inflammatory response and benign hyperplasia, while ADC value is better than DWI image in the clinical efficiency.%目的:分析比较并1.5T磁共振弥散加权成像(DWI)和表观弥散系数(ADC)在局限性前列腺癌与慢性炎性反应和良性增生鉴别诊断中的价值.方法:选取医院收治的80例局限性前列腺癌患者,测量病灶的DWI图像上信噪比(SNR)、ADC值和DWI半定量分级,应用受试者操作特征(ROC)曲线比较诊断效能.结果:在80例局限性前列腺癌患者中,外周带恶性病变52处、良性病变43处;中央腺体恶性病变31处、良性病变46处.外周带和中央腺体患前列腺癌的ADC值分别为0.91±0.12和0.86±0.15,显著低于正常组织(1.68±0.23和1.28±0.31)与良性病变(1.24±0.21和1.12±0.16);外周带和中央腺体良性病变的DWI半定量分级显著高于恶性病变,其差异有统计学意义(x2=20.88,x2=12.14;P<0.05).ADC值诊断效能外周带和中央腺体良恶性病变的灵敏度为91.3%和79.1%,特异度分别为89.6%和70.2%;诊断效能显著高于DWI图像的灵敏度(71.2和51.3)和特异度(78.4和65.8).结论:1.5T磁共振DWI与ADC均为鉴别诊断局限性前列腺癌与慢性炎性反应和良性增生的重要指标,但ADC值在临床上的效能比DWI图像更优良.