DCE-MRI渗透性参数及DWI成像ADC值与前列腺癌Gleason评分的相关性研究

摘要

Objective To evaluate the correlation of permeability parameters of dynamic contrast-enhanced MRI(DCE-MRI)and ADC Values of diffusion weighted imaging(DWI)with Gleason scores of prostate cancer(PCa). Methods 37 patients suspected with prostate cancer underwent conventional MRI,DWI and DCE-MRI,and all patients were confirmed by pathology. The ADC values and the quantitative permeability parameters such as Ktrans,Kep,Ve,Vp of the lesions and normal tissues were calculated and compared. Statistical analysis was performed using two-matched t-test and spearman correlation analysis. Results The Ktrans,Kep,Ve,Vp and ADC values of the malignant lesions were(2.40±1.13)min-1,(1.90±0.72) min-1,(0.82±0.24),(0.31±0.25)and(0.93±0.43)×10-3mm2/s,while the normal tissues were(0.89±0.46)min-1,(0.82±0.42)min-1, (0.86±0.17),(0.09±0.06)and(1.77±0.30)×10-3mm2/s,respectively. The difference of the Ktrans,Kep,Vp and ADC values between the malignant lesions and the normal tissues was statistically significant(P<0.01),while the difference of the Ve was not significant(P=0.292). The ADC values of the lesions were moderate negatively correlated with the main structural grade,secondary structure grade and Gleason scores of prostate cancer(P<0.01). There was low negative correlation between Vp and the main structural grade(P<0.05),but there was no significant correlation between Vp and the secondary structure grade and Gleason scores of prostate cancer(P>0.05). Ktrans,Kep and Ve had no significant correlation with the main structural grade,secondary structure grade and Gleason scores of prostate cancer(P>0.05). Conclusions There is low negative correlation between Vp and the main structural grade, The ADC values of the malignant lesions are moderate negatively correlated with the main structural grade,secondary structure grade and Gleason scores of prostate cancer,while Ktrans,Kep and Ve have no significant correlation with the Gleason scores of prostate cancer.%目的 探讨动态增强磁共振成像(DCE-MRI)血管渗透性参数及弥散加权成像(DWI)ADC值与前列腺癌(PCa)Gleason评分的相关性.方法 收集37例经病理证实的PCa患者,均行磁共振常规扫描、DWI和DCE-MRI扫描.分别测量癌区和正常区域的Ktrans、Kep、Ve、Vp和ADC值,统计学分析采用两配对样本t检验和spearman相关分析.结果 PCa区的Ktrans、Kep、Ve、Vp和ADC值分别为(2.40±1.13)min-1、(1.90±0.72)min-1、(0.82±0.24)、(0.31±0.25)和(0.93±0.43)×10-3mm2/s,正常区域的Ktrans、Kep、Ve、Vp和ADC值分别为(0.89±0.46)min-1、(0.82±0.42)min-1、(0.86±0.17)、(0.09±0.06)和(1.77±0.30)×10-3mm2/s,其中Ktrans、Kep、Vp和ADC值两组差异均具有统计学意义(P值均<0.01),Ve两组差异无统计学意义(P=0.292).PCa区ADC值与PCa的主要结构分级、次要结构分级和Gleason评分均呈中度负相关(P均<0.01),PCa区Vp与PCa的主要结构分级呈低度负相关(P<0.05),与次要结构分级和Gleason评分无明显相关性,Ktrans、Kep和Ve与PCa的主要结构分级、次要结构分级和Gleason评分均无明显相关性(P>0.05).结论 PCa区Vp与PCa的主要结构分级呈低度负相关,ADC值与PCa的主要结构分级、次要结构分级和Gleason评分均呈中度负相关,Ktrans、Kep和Ve与Gleason评分均无明显相关性.