【摘要】 目的:分析前列腺癌(PCa)和前列腺增生(BPH)的体素内不相干运动(IVIM)参数,旨在评价IVIM对PCa和BPH的鉴别诊断价值。方法:回顾性分析72例经病理证实PCa(n=32)和BPH(n=40)患者的3.0T MR图像,扫描序列包括常规T2WI、DWI、LAVA平扫及动态增强和IVIM。IVIM成像,扫描采用EPI-STIR序列,b值=0、20、50、100、200、400、600、800、1000和1200s/mm2。利用GE Functool 4.5工作站的MADC软件,测量PCa和BPH组的标准ADC、慢ADC、快ADC和快ADC分数值,PCa和BPH组的各参数比较采用独立样本t检验。采用受试者工作曲线(ROC)分析标准ADC值、慢ADC值对PCa和BPH的鉴别效能,获得相应曲线下面积(AUC)、诊断PCa的阈值以及相应灵敏度、特异度、阳性预测值(PPV)、阴性预测值(NPV)和准确度。结果:PCa的标准ADC值和慢ADC值分别为(6.21±2.35)×10-4和(7.11±2.49)×10-4 mm2/s,BPH的标准ADC值和慢ADC值分别为(11.11±2.62)×10-4和(12.65±1.81)×10-4 mm2/s,PCa者明显低于BPH者,二者之间的差异具有统计学意义。PCa和BPH的快ADC值和快ADC值分数之间的差异无统计学意义。标准ADC值、慢ADC值AUC分别为0.912和0.947。以8.325×10-4 mm2/s作为标准ADC值的阈值,其诊断PCa的敏感度为78.13%,特异度为97.50%,PPV为96.15%,NPV为84.78%,准确率为88.89%。以10.03×10-4 mm2/s作为慢ADC值的阈值,其诊断PCa的敏感度为87.50%,特异度为95.00%,PPV为93.33%,NPV为90.48%,准确率为91.67%。结论:IVIM的定量参数标准ADC和慢ADC值对PCa和BPH鉴别诊断效能好,可作为前列腺增生基础上PCa检出良好的指标。更多还原

【Abstract】 Objective:To analyze the intra-voxel incoherent motion(IVIM)imaging on differentiation of prostate cancer(PCa)and benign prostate hyperplasia(BPH).Methods:This retrospective study was approved by IRB.Seventy-two patients were divided into group PCa(n=32)and group BPH(n=40).Axial T2WI、DWI、LAVA dynamic contrast enhancement and IVIM imaging with EPI-STIR sequence was obtained from GE Signa 3.0T MR scanner with 10 bvalues of0,20,50,100,200,400,600,800,1000,1200s/mm2,respectively.The standardADC,slowADC,fastADC and fraction of fastADC were measured with MADC software in GE Functool 4.5workstation.These four parameters from PCa and BPH groups were compared using the independent t test.Cut-off values of standard ADC and slowADC were evaluated with receiver operator characteristic(ROC)analysis.Results:The mean standardADCand slowADCvalues were(6.21±2.35)×10-4 mm2/s and(7.11±2.49)×10-4 mm2/s for the PCa group,and(11.11±2.62)×10-4 mm2/s and(12.65±1.81)×10-4 mm2/s for the BPH group.The mean standard ADC and slow ADC values for PCa group were significantly lower than that of BPH group.The AUC of standardADCand slowADC was 0.912 and 0.947.A threshold of 8.325×10-4 mm2/s for the maximum standardADCvalue in the diagnosis of PCa resulted in a sensitivity of 78.13%,and a specificity of 97.50%.The positive predictive value(PPV),negative predictive value(NPV)and diagnostic accuracy for PCa were 96.15%,84.78% and 88.89%,respectively.A threshold of 10.03×10-4 mm2/s for the maximum slowADCvalue in the diagnosis of PCa resulted in a sensitivity of 87.50%,and a specificity of 95.00%.The PPV,NPV and diagnostic accuracy for PCa were 93.33%,90.48% and91.67%,respectively.Conclusion:The standardADCand slowADCvalues are significant IVIM index to differentiate PCa from BPH with satisfying sensitivity and specificity.更多还原