3．0T动态增强MRI在前列腺癌诊断中的价值

摘要

Objective:To assess the diagnostic value of dynamic contrast-enhanced MRI (DCE-MRI)in prostate canc-er with the quantitative analysis of prostate cancer by DCE-MRI.Methods:Forty-six patients with prostate diseases,aged between 43 and 81,including 35 patients with prostate cancer and 11 with prostate hyperplasia were selected.All the pa-tients were conducted with conventional MRI and DCE-MRI scan.The variations of the value of Ktrans ,Kep ,and Ve between the prostate cancer and normal tissues were measured and compared.And under the ROC curve analysis,we calculated the sensitivity and specificity of Ktrans ,Kep and Ve in the diagnosis of prostate cancer,as well as the correlation between Ktrans , Kep ,Ve and the Gleason score in prostate cancer.Results:The values of both Ktrans and Kep were significantly different be-tween the prostate cancer and normal tissues,while Ve was not.The areas of Ktrans、Kep under the ROC curve were the lar-gest,and the sensitivity and specificity of both parameters were 94.6%、92.9% vs 85.7%、71.4% ,yet,Ve was clinically useless in the diagnosis of prostate cancer.Meanwhile,Ktrans ,Kep and Ve values were not relevant with Gleason score.Con-clusion:DCE-MRI quantitative analysis plays a significant role in the diagnosis of prostate cancer,and may help in differenti-al diagnosis of prostate tumors.%目的：通过动态增强 MRI（DCE-MRI）对前列腺癌进行定量分析，评估DCE-MRI在前列腺癌中的诊断价值。方法：选取46名前列腺疾病患者，年龄43～81岁，包括前列腺癌患者35名，前列腺增生患者11名。所有患者均行常规MRI及DCE-MRI检查，在灌注参数图上测量前列腺癌与正常组织的容积转运常数（Ktrans ）、速率常数（Kep ）、血管外细胞外容积分数（Ve ）值，比较三者在前列腺癌及正常组织中的差异，并进行ROC曲线分析，计算Ktrans、Kep、Ve 诊断前列腺癌的敏感度及特异度并对Ktrans、Kep、Ve 三者与Gleason评分进行相关性分析。结果：在前列腺癌与正常组织中，Ktrans、Kep差异均有统计学意义（P＜0．001），Ve 差异无统计学意义（P＞0．05）。Ktrans、Kep的ROC 曲线下面积最大，两者的诊断敏感度及特异度分别为94．6％、92．9％和85．7％、71．4％。Ve 在前列腺癌诊断中无明显价值。Ktrans、Kep、Ve 与Gleason评分无明显相关性。结论：DCE-MRI定量分析在前列腺癌诊断中具有较高价值，可用于前列腺良恶性病变的鉴别诊断。