目的：探讨磁共振扩散加权成像（DWI）及表观扩散系数（ADC）值、3.0T MRI动态对比增强（DCE-MRI）对前列腺癌（Prostate cancer，PCa）伴发精囊腺侵犯（Seminal vesicle invasion，SVI）的诊断价值。方法：对50例PCa患者行DWI及DCE-MRI扫描，观察SVI的DWI及DCE-MRI表现，分别测量PCa癌灶、SVI以及正常精囊腺（Normal seminal vesicle，NSV）的ADC值并绘制出信号强度-时间（SI-T）曲线，计算出达峰时间（Tmax）、最大强化程度（SImax%）和最快强化率（Rmax），作统计学分析，并计算两种检查方法的敏感性、特异性及准确性。结果：本组PCa癌灶、SVI的DWI呈高信号影，ADC图呈低信号影。PCa癌灶、SVI、NSV的ADC值分别为（0.928±0.128）×10-3 mm2/s、（0.965±0.161）×10-3 mm2/s、（2.785±0.235）×10-3 mm2/s。SVI的ADC值明显低于NSV（t=20.896，P<0.05）， PCa癌灶与SVI的ADC值之间无明显统计学意义（t=2.013，P>0.05；F＝1.423，P>0.05）。PCa伴发SVI DCE-MRI表现为早期明显强化，SI-T曲线以速升缓降型和速升平台型多见，侵犯组和非侵犯组Tmax、SImax%、Rmax差异均有统计学意义（t＝－9.05、4.75、16.95，P＜0.05），DWI及DCE-MRI联合应用明显提高诊断的敏感性、特异性和准确性。结论：ADC值联合DCE-MRI有助于PCa伴发SVI的诊断。
Abstract
Objective: To explore the diagnostic value of apparent diffusion coefficient(ADC) and magnetic resonance dynamic contrast-enhanced imaging(DCE-MRI) in prostate cancer(PCa) and seminal vesicle invasion(SVI). Methods: DWI and DCE-MRI data of 50 cases of pathologically proved PCa was retrospectively analyzed. DWI and ADC map appearance of all Pca foci, SVI and normal seminal vesicle(NSV) were analyzed. And their ADC mean values were measured. The styles of the SI-T were analyzed. Tmax, SImax%, Rmax were calculated. Sensitivity, specificity and accuracy were calculated also. Results: All PCa foci and SVI showed high signal intensity on DWI and low signal intensity on ADC map. The mean ADC values of PCa, SVI, NSV were (0.928±0.128)×10-3 mm2/s, (0.965±0.161)×10-3 mm2/s, (2.785±0.235)×10-3 mm2/s respectively. There was statistical significance among the SVI and NSV(t=20.896, P<0.05). There was no statistical significance among the PCa and SVI(t=2.013, P>0.05; F＝1.423, P>0.05). PCa and SVI in DCE-MRI showed early enhanced, the common styles of SI-T curves were rapidly ascending followed with descending curve. The value of Tmax, SImax%, Rmax in SVI and NSV were statistical significant(t＝-9.05, 4.75, 16.95, P＜0.05). DWI combined DCE-MRI can obviously increase the diagnostic sensitivity, specificity and accuracy. Conclusion: ADC combined with DCE-MRI might be helpful in diagnosis of PCa and SVI.
关键词
前列腺肿瘤 /
磁共振成像
Key words
Prostatic neoplasms /
Magnetic resonance imaging
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参考文献
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