Objective To discuss on the value of dynamic contrast-enhanced MRI(DCE-MRI)and diffusion-weighted imaging(DWI) in diagnosising prostate cancer(PCa)and its relationship with prostate-specific antigen(PSA)expression. Methods A retrospective analysis of 66 cases of PCa and 30 cases of benign prostatic hyperplasia(BHP)in our hospital,all patients were diagnosed by pathology based on the final diagnosis,and underwent conventional MRI,DCE-MRI,DWI examination and serum levels of PSA testing.Compared the differences of PCa and BHP in the DCE-MRI signal intensity-time(SI-T)curve,parameters value and apparent diffusion coefficient(ADC)in DWI,and used Person correlation analysis to analyze the correlation between the diagnostic parameters and PSA. Results In DCE-MRI,PCa and BHP at peak time[(69224.14±18245.14)vs(82911.42±26742.37)],the maximum slope of increase(231.83±38.15 vs 187.35±39.35)],signal enhancement ratio[(124.29±14.42)vs(101.31±10.24)]and Ⅲ in the DWI,[(0.73±0.21)vs(1.00±0.19)]and the index of apparent PCa and BHP in ADC type SI-T curve type number of cases(42 cases vs 3 cases)the differences were statistically significant(P<0.05)diffusion coefficient[(0.51±0.08)vs(0.39±0.08)],the difference was statistically significant(P<0.05).In addition,DCE-MRI diagnosis of PCa joint DWI accuracy of up to 91.7%,higher than DCE-MRI(78.2%)or DWI(78.1%),in the area under the ROC curve lines,ADC was higher than other indicators,and the ADC and PAS had a negative correlation(r=-0.572,P=0.032). Conclusion DCE-MRI and DWI have a certain diagnostic value in differentiating PCa and BHP,and the combination of both can improve the diagnostic accuracy.In addition, ADC values can be used as a basis for PAS expression changes.%目的 探讨MRI动态增强(DCE-MRI)和弥散加权成像(DWI)在前列腺癌(PCa)临床诊断中的应用价值及其与前列腺特异性抗原(PSA)表达水平的相关性.方法 回顾性分析66例PCa患者及30例前列腺增生(BHP)患者临床诊断资料,所有患者均以病理诊断结果为最终诊断依据,并进行MRI常规、DCE-MRI、DWI检查及血清PSA水平检测,比较PCa及BHP在DCE-MRI中的信号强度-时间(SI-T)曲线及各参数值差异,比较两者在DWI中表观弥散系数值(ADC)差异,并采用Person相关性分析各诊断参数与PSA的相关性.结果 在DCE-MRI中,PCa和BHP在达峰时间[(69224.14±18245.14)vs(82911.42±26742.37)]、最大增强斜率[(231.83±38.15)vs(187.35±39.35)]、信号增强率[(124.29±14.42)vs(101.31±10.24)]以及Ⅲ型SI-T曲线类型病例数(42例vs 3例)上差异均具有统计学意义(P<0.05);在DWI中,PCa和BHP在ADC[(0.73±0.21)vs(1.00±0.19)]及指数表观扩散系数[(0.51±0.08)vs(0.39±0.08)],差异具有统计学意义(P<0.05);此外,DCE-MRI联合DWI诊断PCa准确度可达91.7%,高于单独使用DCE-MRI(78.2%)或DWI(78.1%),在ROC曲线线下面积中,ADC高于其他指标,且ADC与PAS具有一定的负相关性(r=-0.572,P=0.032).结论 DCE-MRI、DWI在鉴别PCa与BHP中具有一定诊断价值,且联合两者可提高诊断准确度,此外,ADC值可作为PAS表达水平变化的支持依据.
展开▼
