【摘要】 目的探讨动态增强磁共振成像(Dynamic Contrast-Enhanced Magnetic Resonance Imaging,DCE-MRI)定量参数在前列腺癌和前列腺增生鉴别诊断中的价值;分析定量参数与前列腺癌病理Gleason评分的相关性。方法对156例确诊前列腺增生和前列腺癌患者行DCE-MRI检查,其中前列腺癌61例,前列腺增生95例。对其定量参数进行均值、标准差及百分位数并方差分析;同时分析前列腺癌中DCE-MRI定量参数与病理Gleason评分相关性。结果与前列腺增生组比较,前列腺癌组容量转移常数(Volume Transfer Constant,Ktrans)、管外细胞外的间隙的容量分数(Fraction Volume of the Extravascular Extracellular Space,Ve)、血浆容积(Volume Blood Plasma,Vp)三者的平均值、标准差、50%位数、75%位数、90%位数明显较高(P值均<0.01);前列腺癌组Kep值10%位数显著降低,且Kep值10%位数在两组鉴别诊断中准确性较高;若以Kep值10%位数<0.01作为前列腺癌诊断标准,其敏感度为66.7%,特异性为72.7%。直线相关与回归分析发现:前列腺癌组DCEMRI定量参数中,Ktrans及Ve各参数与Gleason评分呈线性相关。结论 DCE-MRI定量反映前列腺组织微血管分布和灌注信息;其中多项定量参数能用于鉴别前列腺增生和前列腺癌,且与Gleason评分线性相关,能反映病变分级信息。更多还原

【Abstract】 Objective To explore the value of dynamic enhanced magnetic resonance imaging(DCE-MRI) quantitative parameters in the differential diagnosis of prostate cancer and prostatic hyperplasia, and to understand the correlation between quantitative parameters and pathological Gleason score of prostate cancer. Methods A total of 156 cases(61 prostate cancer and 95 prostatic hyperplasia) were treated with DCE-MRI. The mean, standard deviation and percentile and variance analysis of the quantitative parameters were analyzed. Meanwhile, the association of quantitative parameters of DCE-MRI in prostate cancer and pathologic Gleason score was analyzed. Results Compared with the prostate hyperplasia group, the average, standard deviation, 50%, 75%, and 90% of the Ktrans, Ve and Vp in prostate cancer group were signifi cantly higher(P<0.01) than that of benign prostate prostatic hyperplasia group. The Kep value of the prostate cancer group was signifi cantly reduced by 10%, and the accuracy rate was the highest when the Kep value was in 10 th percentile. The sensitivity was 66.7% and the specifi city was 72.7%, if the Kep value was 10% lower than that of prostate cancer. Linear correlatio n and regression analysis showed that the parameters of DCE-MRI in prostate cancer group were in linearly dependent on the parameters of Ktrans and Ve on Gleason’s. Conclusion DCE-MRI can quantitatively refl ect the distribution and perfusion of microvascular in prostate. Multiple quantitative para meters can be applied to the differential diagn osis of prostate cancer and prostatic hyperplasia, and multiple quantitative parameters have linear correlations with the Gleason’s score in the pathology of prostate cancer, and can refl ect the tumor grade and stage.更多还原