高b值DWI对低PSA水平前列腺癌和前列腺增生伴间质炎的鉴别诊断价值

摘要

Objective To investigate the value of high b value DWI in discriminating prostate cancer ( Pca) from benign pros-tatic hyperplasia (BPH) with prostatitis.Methods 21 patients with low level PSA Pca (PSA level <10μg/l) and 25 BPH with prostatitis patients underwent MR plain scan and high b value diffusion-weighted imaging (b value=0, 2000 s/mm2).The le-sions's apparent diffusion coefficient (ADC) value were measured and the PSA levels were collected .The differences of the ADC values between low level PSA Pca and BPH with prostatitis were compared .Receiver operating characteristic ( ROC) curve was used for the differential efficiency .Results The ADC values ( ×10-3 mm2/s ) of low level PSA Pca and BPH with prostatitis were 0.663 ±0.148 vs 0.886 ±0.257, there was statistic significance ( P =0.0011).Area under the ROC curve was 0.768, cut off value was 0.0008, sensitivity was 71.4%, specificity was 72%.Conclusion High b value DWI is a useful diagnostic tool to detect low PSA level Pca from BPH with prostatitis .%目的 探讨高b值DWI对低PSA水平前列腺癌和前列腺增生伴间质炎的鉴别诊断价值.方法 收集经病理证实的PSA水平<10μg/l的前列腺癌患者21例及前列腺增生伴间质炎25例的高b值序列DWI扫描数据.测量病灶区ADC值.t检验比较低PSA水平前列腺癌与前列腺增生伴间质炎之间的ADC值的差别.受试者工作曲线(ROC曲线)评估ADC值的诊断效能.结果 低水平PSA前列腺癌组与前列腺增生伴间质炎组病灶的ADC值(×10-3 mm2/s)分别为:0.663±0.148 vs 0.886±0.257,差别有统计学意义(P值0.0011).鉴别低水平PSA的前列腺癌与前列腺增生伴间质炎ROC曲线下面积0.768,阈值0.0008,敏感度71.4%,特异度72%.结论 高b值DWI对低PSA水平前列腺癌和前列腺增生伴间质炎的鉴别诊断有很好的应用价值.