动态对比增强MRI定量分析鉴别不同级别前列腺癌

摘要

目的 探讨动态对比增强MRI(DCE-MRI)鉴别低级别与高级别前列腺癌的价值.方法 回顾性分析经前列腺癌根治术后病理证实并于术前接受前列腺DCE-MRI的26例前列腺癌患者的资料,根据病理结果分为低级别组(n=10)和高级别组(n=16),测量并比较2组间前列腺癌转运常数(Ktrans)、速率常数(Kep)及血管外细胞外间隙体积百分数(Ve)的差异,绘制ROC曲线,评价各参数值鉴别低级别与高级别前列腺癌的诊断效能,并分析各参数与Gleason评分的相关性.结果 低级别前列腺癌组Ktrans、Kep及Ve值分别为(0.22±0.07)/min、(1.24±0.57)/min和0.21±0.08,高级别组分别为(0.36±0.10)/min、(1.82±0.66)/min和0.21±0.10,2组间Ktrans及Kep值差异均有统计学意义(P均＜0.05),Ve值差异无统计学意义(P=0.994).Ktrans、Kp值区分前列腺高级别癌和低级别癌的ROC曲线下面积分别为0.872和0.737.前列腺癌Ktrans、Kep、Ve值与Gleason评分均无相关(P均＞0.05).结论 DCE-MRI定量参数Ktrans和Kep有助于鉴别低级别与高级别前列腺癌.%Objective To investigate the value of quantitative analysis parameters of dynamic contrast-enhanced MRI (DCE-MRI) in distinguishing low or high grade prostate cancer.Methods Data of DCE-MRI in 26 patients with prostate cancer confirmed by surgical pathology following radical prostatectomy were retrospectively analyzed.These patients were divided into low grade prostate cancer (n=10) group or high grade prostate cancer group (n=16).The parameters,including transport constant (K trans),rat constant (Kep) and extravascular extracellular volume fraction (Vc.) were measured and compared between the two groups.ROC curve was used to determine the efficacy of the parameters in distinguishing low or high grade prostate cancer.The correlation between the parameters and Gleason score were assessed.Results Ktrans,Kep and Ve values in the low grade prostate cancer group was (0.22± 0.07)/min,(1.24 ± 0.57)/min and 0.21±0.08 respectively,and (0.36±0.10)/min,(1.82±0.66)/min,0.21±0.10 respectively in the high grade prostate cancer group.The differences of K trans and Kep were statistically significant between the two groups (both P＜0.05),while of Vc.was not statistically significant (P=0.994).The area under ROC curves of K trans and keapvalues for distinguishing low or high grade prostate cancers was 0.872 and 0.737,respectively.No correlation was found between any parameters nor Gleason scores (all P＞0.05).Conclusion K trans and Kep,the quantitative analysis parameters of DCE-MRI,contribute to the differential diagnosis of low and high grade prostate cancer.