【摘要】 目的通过对比T2WI及T2WI联合扩散加权成像(diffusion weighted imaging,DWI)和动态增强(dynamiccontrastenhancement,DCE)3种序列及联合应用在慢性前列腺炎与前列腺癌的诊断效能,探讨运用于前列腺病变磁共振诊断的最佳序列。材料与方法选取2014年6月至2020年6月经MRI检查发现前列腺外周带T2WI低信号的38例患者共43个病灶为研究对象,对其临床病理及影像学资料进行回顾性分析,总结各序列及联合应用的诊断效能。结果慢性前列腺炎共26个病灶,前列腺癌共17个病灶,炎性病灶、癌灶与正常组织ADC值之间经方差分析,差异有统计学意义(P<0.05)。以ADC值<0.92×10-3mm2/s作为诊断前列腺癌的标准,敏感性为96.2%,特异性为88.2%。T2WI:诊断前列腺癌的敏感性和特异性分别为52.94%、69.23%,准确率为62.79%,T2WI的诊断效能与手术病理对照,一致性程度差(Kappa值=0.222)。T2WI+DWI:诊断前列腺癌的敏感性和特异性分别为94.12%、82.46%,准确率为90.70%,T2WI+DWI的诊断效能与手术病理对照,一致性程度非常满意(Kappa值=0.809),与T2WI+DWI+DCE联合应用的诊断效能相当。结论 T2WI+DWI的诊断效能与T2WI+DWI+DCE联合应用的诊断效能无明显差异,值得推广应用。更多还原

【Abstract】 Objective: By comparing the three sequences of T2 WI and T2 WI combined with DWI and DCE and their combined efficacy in the diagnosis of chronic prostatitis and prostate cancer, the optimal sequence of MRI in the diagnosis of prostate lesions was discussed. Materials and Methods: A total of 43 lesions were selected from 38 patients with low T2 WI signal found in peripheral prostate gland by MRI examination from June 2014 to June 2020, and the clinical pathological and imaging data were retrospectively analyzed to summarize and analyze the diagnostic efficacy of each sequence and combined application. Results: There were 26 lesions in chronic prostatitis and 17 lesions in prostate cancer. The differences between the ADC values of inflammatory lesions, cancer foci and normal tissues were statistically significant by variance analysis(P<0.05). ADC value 0.92×10-3 mm2/s was used as the standard for detection of prostate cancer, with sensitivity of 96.2% and specificity of 88.2%. T2 WI: The sensitivity and specificity of the diagnosis of prostate cancer were 52.94% and 69.23%, respectively, and the accuracy of the diagnosis of prostatitis and prostate cancer was 62.79%. The diagnostic efficacy of T2 WI was compared with that of surgery and pathology, with poor consistency(Kappa=0.222). T2 WI+DWI: The diagnostic sensitivity and specificity of T2 WI+DWI for prostate cancer were 94.12% and 82.46% respectively, and the diagnostic accuracy for prostatitis and prostate cancer was 90.70%. The diagnostic efficacy of T2 WI+DWI was compared with that of surgery and pathology, and the diagnostic efficacy was very satisfactory(Kappa=0.809), which was comparable to the combined application of T2 WI+DWI+DCE. Conclusions: The diagnostic efficacy of T2 WI+DWI is not significantly different from that of T2 WI+DWI+DCE, so it is worth popularizing and applying.更多还原