目的：探讨多模态MRI技术对早期前列腺癌的诊断价值。方法：收集行前列腺MRI检查的前列腺疾病患者100例，以病理学诊断为金标准，所有患者均行T2WI、DWI和DCEI检查。组合上述3种检查形成以下4种方案：方案1：T2WI；方案2：T2WI+DWI；方案3：T2WI+DCEI；方案4：T2WI+DWI+DCEI。对影像与病理对照结果进行ROC曲线分析，Z检验比较各组方案的曲线下面积（AUC），并计算各组方案的敏感度、特异度和准确度。结果：4种检查方案中，方案4的诊断敏感度、特异度及准确度最高，分别为92.6%、87.0%及90%，方案1的诊断敏感度、特异度及准确度最低，分别为68.5%、63.0%及66%。各组方案AUC值从大到小依次为：方案4：0.916、方案2：0.908、方案3：0.870、方案1：0.697，方案1与方案2、方案3及方案4间的AUC值比较均有统计学差异（P＜0.05），方案2、方案3及方案4间两两比较AUC值均无统计学差异（P＞0.05）。结论：T2WI+DWI，T2WI+DCEI和T2WI+DWI+DCEI对早期前列腺癌均有较高的诊断价值，其中T2WI+DWI较T2WI+DCEI临床应用价值更高，而T2WI+DWI+DCEI诊断能力最强。
Abstract
Objective: To evaluate the diagnostic value of multi-parametric MRI for early prostate cancer. Methods: One hundred patients with prostatic diseases were scanned with MRI, all cases were pathological diagnosis as the gold standard, and they underwent T2WI, DWI and DCEI. Four protocols were formed by combination of above three technologies: T2WI (protocol 1), T2WI+DWI(protocol 2), T2WI+DCEI(protocol 3), T2WI+DWI+DCEI(protocol 4). The image data was diagnosed and made contrast with pathological findings. The AUC value of each protocol in the diagnosis of prostate cancer was compared with Z-test, and the sensitivity, specificity and accuracy for each protocol were calculated. Results: In the four protocols, the sensitivity, specificity and accuracy for protocol 4 in the diagnosis of prostate cancer were the highest(92.6%, 88.9% and 90%), the sensitivity, specificity and accuracy for protocol 1 were the lowest(68.5%, 63.0% and 66%). The AUC value of 4 protocols in descending order: protocol 4(0.916), protocol 2(0.908), protocol 3(0.870) and protocol 1(0.697). There were significant differences in AUC values between protocol 1 and 2, protocol 1 and 3, protocol 1 and 4(P＜0.05). There were not significant differences in AUC values between protocol 2 and 3, protocol 2 and 4, protocol 3 and 4(P＞0.05). Conclusion: T2WI+DWI, T2WI+DCEI and T2WI+DWI+DCEI have highly diagnostic value for early prostate cancer, the clinical value of T2WI+DWI is higher than that of T2WI+DCEI, and T2WI+DWI+DCEI is the best diagnostic efficiency.
关键词
前列腺肿瘤 /
磁共振成像
Key words
Prostatic neoplasms /
Magnetic resonance imaging
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基金
广东省医学科学技术研究基金资助项目（A2015291）；广东省科技计划资助项目（2014A020212665）。
