發(fā)布時(shí)間：2018-03-18 22:26

  本文選題：前列腺腫瘤　切入點(diǎn)：磁共振動(dòng)態(tài)對(duì)比增強(qiáng)　出處：《第三軍醫(yī)大學(xué)學(xué)報(bào)》2017年22期 　論文類型：期刊論文

【摘要】：目的探討磁共振動(dòng)態(tài)對(duì)比增強(qiáng)(dynamic contrast enhanced magnetic resonance imaging,DCE-MRI)定量參數(shù)直方圖分析對(duì)前列腺癌檢出的應(yīng)用價(jià)值。方法收集本院2016年10月至2017年6月行盆腔常規(guī)MRI、DWI和DCE-MRI掃描的患者72例,經(jīng)病理證實(shí)的前列腺癌(prostate cancer,PCa)38例,前列腺增生(prostatic hyperplasia,BPH)18例,結(jié)合影像表現(xiàn)、實(shí)驗(yàn)室檢查及隨訪觀察診斷前列腺炎16例。利用第三方后處理軟件(Omni Kinetic,OK),在病灶最大中心層面勾畫感興趣區(qū),獲得感興趣區(qū)內(nèi)DCE-MRI定量參數(shù)(Ktrans、Kep和Ve)的平均值及各百分位數(shù)值(5%、10%、25%、50%、75%、90%和95%),分別比較外周帶PCa與前列腺炎、中央腺體PCa與BPH各參數(shù)值的差異,并分析診斷效能。結(jié)果外周帶PCa組Ktrans平均值及各百分位數(shù)值均大于前列腺炎(平均值及50%、75%、90%和95%百分位數(shù)值P0.05)。PCa組Kep平均值及各百分位數(shù)值均大于前列腺炎(P0.05)。外周帶PCa組Ve平均值及各百分位數(shù)值小于或等于前列腺炎(5%、10%、25%和50%百分位數(shù)值P0.05)。中央腺體PCa與BPH滲透參數(shù)Ktrans、Kep、Ve的平均值及各百分位數(shù)值差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。外周帶PCa組Ktrans和Kep高百分位數(shù)AUC大于平均值,低百分位數(shù)AUC最小,90%Kep診斷效能最大(AUC為0.932,敏感度78.3%,特異度92.9%);外周帶PCa組Ve百分位數(shù)不具有診斷效能。結(jié)論基于DCE-MRI的直方圖分析在外周帶PCa與前列腺炎鑒別診斷中具有臨床價(jià)值,Ktrans、Kep高百分位數(shù)診斷效能優(yōu)于平均值和低百分位數(shù)。
[Abstract]:Objective to evaluate the value of dynamic contrast enhanced magnetic resonance imagingMr histogram analysis in the detection of prostate cancer. Methods from October 2016 to June 2017, 72 patients with conventional contrast magnetic resonance imaging DWI and DCE-MRI were collected from our hospital. There were 38 cases of prostate cancer, 18 cases of prostatic hyperplasia, and 18 cases of pathologically proved prostate cancer. Sixteen cases of prostatitis were diagnosed by laboratory examination and follow up observation combined with the imaging findings. The third party post-processing software Omni Kineticus OKA was used to draw the area of interest at the largest central level of the lesion. The average value and the percentile value of DCE-MRI quantitative parameters (KTranskep and Veg) in the region of interest were obtained. The difference of parameters between peripheral PCa and prostatitis, central glandular PCa and BPH was compared, and the values of five percentiles were 5% and 50%, 75%, 90% and 95%, respectively, in the peripheral zone and prostatitis, central gland PCa and BPH, respectively. Results the mean value and percentile value of Ktrans in peripheral PCa group were higher than that in prostatitis group (mean value and 95% percentile value P0.05U 路PCA group were higher than that in prostatitis group P0.050.The peripheral zone was larger than that in the peripheral zone. The mean value of ve and percentile of PCa group were less than or equal to that of prostatitis group (25%) and the value of 50% percentile (P0.05). There was no significant difference between the mean value of PCa of central gland and that of BPH osmotic parameter Ktranskepus V and the value of percentile of BPH. There was no significant difference between the mean value of PCa and the value of each percentile of BPH in the peripheral PCa group (P 0.05). And the Kep high percentile AUC is greater than the average, The diagnostic efficacy of low percentile AUC was 0.932, the sensitivity was 78.3, the specificity was 92.99.The ve percentile of peripheral PCa group was not effective. Conclusion the histogram analysis based on DCE-MRI is useful in the differential diagnosis of peripheral PCa and prostatitis. The high percentile value of KtransP Kep is superior to the average and low percentile.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第二醫(yī)院放射科;
【基金】：國家自然科學(xué)基金青年科學(xué)基金項(xiàng)目(81401382) 重慶市衛(wèi)計(jì)委醫(yī)學(xué)科研計(jì)劃項(xiàng)目(2016MSXM024,2017MSXM035)~~
【分類號(hào)】：R445.2;R737.25

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