多参数磁共振成像在诊断前列腺癌及疾病危险程度中的应用

doi:10.7517/issn.1674-0475.221102

摘要/Abstract

摘要： 本研究探讨多参数磁共振成像（mpMRI）在诊断前列腺癌（PCA）及疾病危险程度分层评估中的价值。选取经病理学检查确诊的42例PCA患者（PCA组）及45例前列腺良性增生患者（对照组）作为研究对象。采用3.0T磁共振成像仪对所有患者进行mpMRI检查，对比两组患者的表观扩散系数（ADC）、真性扩散系数（D）、扩散分布指数（DDC）、最大强化程度（SImax）、最快强化率（Rmax）、达峰时间（Tmax）、平均峰度（MK）、轴向峰度（Ka）、径向峰度（Kr）、平均扩散系数（MD）差异。以病理学结果作为金标准，计算mpMRI参数联合诊断PCA的临床价值。PCA组患者的SImax、Rmax、MK、Ka、Kr测定值均显著高于对照组（P<0.05），ADC、D、DDC、Tmax、MD测定值均显著低于对照组（P<0.05）。根据风险程度将PCA患者分为高风险组患者（19例）和中低风险组患者（23例），高风险组患者的SImax、Rmax、MK、Ka、Kr测定值均显著高于中低风险组患者（P<0.05），ADC、D、DDC、Tmax、MD测定值均显著低于中低风险组患者（P<0.05）；mpMRI参数联合诊断PCA的ROC曲线下面积（AUC）为1，敏感性为100%，特异性为100%。PCA患者与前列腺良性增生患者的mpMRI参数有差异性，不同疾病风险分层的PCA患者mpMRI参数有差异性，mpMRI参数联合诊断PCA与前列腺良性增生具有较高的临床价值。

关键词: 多参数磁共振成像, 诊断, 前列腺癌, 前列腺良性增生

Abstract: This study explored the value of multi-parameter magnetic resonance imaging (mpMRI) in the diagnosis of prostate cancer (PCA) and the stratified evaluation of disease risk. 42 patients with confirmed PCA patients diagnosed by pathological examination (PCA group) and 45 patients with benign prostatic hyperplasia (control group) were selected as subjects. All patients were examined by mpMRI with 3.0T magnetic resonance imaging. The apparent diffusion coefficient (ADC), true diffusion coefficient (D), diffusion distribution index (DDC), maximum enhancement degree (SImax), fastest enhancement rate (Rmax), time to peak (Tmax), average kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr) and average diffusion coefficient (MD) were compared between the two groups. Taking the pathological results as the gold standard, the clinical value of mpMRI parameters in the diagnosis of PCA was calculated. The measured values of SImax, Rmax, MK, Ka and Kr in the PCA group were significantly higher than those in the control group (P<0.05), while the values of ADC, D, DDC, Tmax and MD were significantly lower than those in the control group (P<0.05). According to the degree of risk, the PCA patients were divided into high risk group (n=19) and middle and low risk group (n=23). In high risk group the measured values of SImax, Rmax, MK, Ka and Kr were significantly higher than those in middle and low risk group, while the values of ADC, D, DDC, Tmax and MD in high risk group were significantly lower than those in middle and low risk group (P<0.05). The area under the ROC curve (AUC) of mpMRI parameter combined diagnosis for PCA was 1, the sensitivity was 100% and the specificity was 100%. There are differences in mpMRI parameters between patients with PCA and patients with benign prostatic hyperplasia, and there are also differences in mpMRI parameters in patients with PCA with different disease risk stratification. The combination of mpMRI parameters in the diagnosis of PCA and benign prostatic hyperplasia has a high clinical value.

Key words: multiparametric magnetic resonance, diagnosis, prostate cancer, benign prostatic hyperplasia

赵燕, 孙勇. 多参数磁共振成像在诊断前列腺癌及疾病危险程度中的应用[J]. 影像科学与光化学, 2023, 41(1): 177-181.

ZHAO Yan, SUN Yong. Application of Multi-Parameter MRI in the Diagnosis of Prostate Cancer and the Risk Stratification of Disease[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2023, 41(1): 177-181.

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