【摘要】 目的 探讨3.0T磁共振弥散张量成像(DTI)技术参数对前列腺增生及前列腺癌诊断及其与Gleason评分危险度分级的关系。方法 选取2021年1月至2023年12月我院收治的疑似前列腺癌患者196例，均进行3.0T磁共振检查获取DTI技术参数，依据病理结果将患者分为前列腺增生组78例和前列腺癌组118例，分析3.0T磁共振诊断结果与病理结果的一致性，比较两组DTI技术参数差异，分析前列腺癌患者DTI技术参数[表观扩散系数(ADC)、各向异性分数(FA)]与Gleason评分危险度分级(ISUP)的相关性及其对前列腺增生及前列腺癌的诊断价值。结果 前列腺癌组入院血清总前列腺特异性抗原(PSA)高于前列腺增生组(P<0.05);3.0T磁共振诊断前列腺增生73例(37.24%)，前列腺癌123例(62.76%)，诊断前列腺癌的灵敏度、特异度和准确率分别为94.92%、85.90%、91.32%，与病理结果的Kappa值为0.817；前列腺癌组ADC值低于前列腺增生组，FA值高于前列腺增生组，差异有统计学意义(P<0.05);118例前列腺癌患者中，Gleason评分6～10分患者数量分别为11例(9.32%)、79例(66.94%)、16例(13.56%)、6例(5.09%)、6例(5.09%),ISUP分级1～5级患者数量分别为11例(9.32%)、39例(33.06%)、40例(33.89%)、16例(13.56%)、12例(10.17%),Spearman相关分析结果显示，前列腺癌患者ADC值与ISUP分级呈正相关，FA值与ISUP分级呈负相关(P<0.05);ROC分析结果显示，ADC值、FA值单独诊断前列腺癌的AUC分别为0.908、0.898，联合诊断的AUC为0.973(P<0.05)。结论 3.0T磁共振DTI技术参数与前列腺癌ISUP分级相关，具有对前列腺增生及前列腺癌的鉴别诊断价值，联合诊断的诊断效能更高。更多还原

【Abstract】 Objective To investigate the diagnostic value of 3.0T magnetic resonance diffusion tensor imaging(DTI) technical parameters on benign prostatic hyperplasia and prostate cancer and the relationship with Gleason score risk classification.Methods A total of 196 patients with suspected prostate cancer in the hospital from January 2021 to December 2023 were selected.All patients underwent 3.0 T magnetic resonance examination to obtain DTI technical parameters [Apparent Diffusion Coefficient(ADC),Fractional Anisotropy(FA)].According to the pathological results,the patients were divided into 78 cases in benign prostatic hyperplasia group and 118 cases in prostate cancer group.The consistency between 3.0 T magnetic resonance diagnosis and pathological result was analyzed.The differences in DTI technical parameters between the two groups were compared.The correlation between DTI technical parameters and Gleason score risk classification(ISUP) in patients with prostate cancer and the diagnostic value on benign prostatic hyperplasia and prostate cancer were analyzed.Results Serum total prostate specific antigen(PSA) in prostate cancer group was higher than that in benign prostatic hyperplasia group(P<0.05).73 cases of benign prostatic hyperplasia(37.24%) and 123 cases of prostate cancer(62.76%) were diagnosed by 3.0T magnetic resonance,and the sensitivity,specificity and accuracy rate in diagnosing prostate cancer were 94.92%,85.90% and 91.32% respectively,and the Kappa value with pathological result was 0.817.The ADC value of prostate cancer group was lower than that of benign prostatic hyperplasia group while the FA value was higher than that of benign prostatic hyperplasia group(P<0.05).Among 118 patients with prostate cancer,the number of patients with Gleason score of 6-10 points were 11 cases(9.32%),79 cases(66.94%),16 cases(13.56%),6 cases(5.09%) and 6 cases(5.09%) respectively,and the number of patients with ISUP grade 1 to 5 were 11 cases(9.32%),39 cases(33.06%),40 cases(33.89%),16 cases(13.56%) and 12 cases(10.17%) respectively.Spearman correlation analysis showed that ADC value of prostate cancer patients was positively correlated with ISUP classification,and FA value was negatively correlated with ISUP classification(P<0.05).ROC analysis results suggested that the AUCs of ADC value and FA value in the diagnosis of prostate cancer were 0.908 and 0.898,and the AUC of combined diagnosis was 0.973(P<0.05).Conclusion The technical parameters of 3.0T magnetic resonance DTI are related to the ISUP classification of prostate cancer,which has the differential diagnosis value on benign prostatic hyperplasia and prostate cancer,and the diagnostic efficiency of combined diagnosis is higher.更多还原