本文選題：前列腺癌 + 磁共振成像�。� 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:評(píng)價(jià)磁共振ADC值定量分析在前列腺癌的診斷及鑒別診斷中的價(jià)值,探討ADC值與前列腺癌Gleason評(píng)分的相關(guān)性,同時(shí)評(píng)價(jià)ADC值在前列腺癌的分級(jí)、治療方案的選擇及預(yù)后評(píng)價(jià)中的價(jià)值。材料與方法:回顧性分析青島大學(xué)附屬醫(yī)院自2010年至2013年經(jīng)超聲引導(dǎo)下穿刺活檢或手術(shù)病理證實(shí)的89例前列腺病例,根據(jù)病理將前列腺病灶分為前列腺癌組、前列腺增生組及正常組織組,記錄各前列腺病灶對(duì)應(yīng)磁共振檢查的ROI的ADC值及前列腺癌各病灶的Gleason評(píng)分。對(duì)照病理結(jié)果分析前列腺癌、前列腺增生、正常前列腺組織的ADC值的差異,同時(shí)做ADC值診斷前列腺癌的ROC曲線分析。分析前列腺癌ADC值與Gleason評(píng)分之間的相關(guān)性及各評(píng)分組間ADC值的差異,同時(shí)做ADC值診斷中高危組前列腺癌的ROC曲線分析。結(jié)果:89例前列腺疾病患者一共獲得有效ROI為543個(gè),前列腺癌病灶對(duì)應(yīng)的ROI為224個(gè),前列腺增生病灶對(duì)應(yīng)的ROI為276個(gè),正常前列腺組織對(duì)應(yīng)的ROI為43個(gè)。前列腺癌病灶與非癌灶對(duì)應(yīng)ROI的ADC值有顯著性差異(U=66250.50,p0.01);前列腺癌組、前列腺增生組、正常組織組的ADC值組間比較有顯著性差異(F=382.359,P0.01);多重比較前列腺癌組與前列腺增生組、正常組的ADC值有統(tǒng)計(jì)學(xué)差異(P0.05),前列腺增生組、正常組織組間ADC值無統(tǒng)計(jì)學(xué)差異(P0.05);根據(jù)ROC曲線分析,截?cái)嘀怠?.08×10~(-3)mm~2/s時(shí),ADC值診斷前列腺癌的特異度和敏感度較高,分別為84.8%和95.9%,可獲得較高的診斷效能;前列腺癌病灶的ADC值與Gleason評(píng)分呈負(fù)相關(guān)(r=-0.439,P0.01);各Gleason評(píng)分組ADC值組間比較有顯著性差異(F=29.755,P0.01),多重比較Gleason評(píng)分=6分組與7分、8分、9分組的ADC值差異有顯著性統(tǒng)計(jì)學(xué)意義(p0.01),Gleason評(píng)分=7分、8分、9分各組的ADC值差異無統(tǒng)計(jì)學(xué)差異(P0.05);根據(jù)ROC曲線,ADC值取截?cái)嘀怠?.997×10~(-3)mm~2/s時(shí),對(duì)區(qū)分中高危組前列腺癌(Gleason評(píng)分≥7分)與低危組前列腺癌(Gleason評(píng)分7分)的特異度和敏感度較高,分別為96.2%和60%,具有較高診斷效能。結(jié)論:磁共振功能成像中的DWI、ADC圖及ADC值定量分析可用來鑒別前列腺癌、前列腺增生和正常前列腺組織,在前列腺疾病的診斷與鑒別診斷中有較高的敏感度和特異度,可作為前列腺疾病常規(guī)磁共振檢查的重要補(bǔ)充。磁共振ADC值與前列腺癌的Gleason評(píng)分之間具有相關(guān)性,ADC值可為評(píng)估前列腺癌的分化及分級(jí)提供較為準(zhǔn)確的定量依據(jù),能為前列腺癌的治療方案的選擇提供較為可靠的定量依據(jù)。根據(jù)磁共振檢查的ADC值可以無創(chuàng)性的評(píng)估前列腺癌的惡性程度和預(yù)后。
[Abstract]:Objective: to evaluate the value of quantitative analysis of ADC value in the diagnosis and differential diagnosis of prostate cancer, to explore the correlation between ADC value and Gleason score of prostate cancer, and to evaluate the value of ADC value in the grading of prostate cancer. The value of choice of treatment regimen and prognosis evaluation. Materials and methods: 89 cases of prostate cancer confirmed by ultrasound guided biopsy or surgery and pathology from 2010 to 2013 in the affiliated Hospital of Qingdao University were retrospectively analyzed. The prostate lesions were divided into prostate cancer group according to the pathology. The ADC value of ROI and Gleason score of prostate cancer were recorded in benign prostatic hyperplasia group and normal tissue group. The difference of ADC in prostate cancer, prostatic hyperplasia and normal prostate tissue was analyzed by comparing the pathological results. The ROC curve of ADC value in diagnosis of prostate cancer was also analyzed. To analyze the correlation between ADC value and Gleason score of prostate cancer, and the difference of ADC value among each score group, and to analyze the ROC curve of prostate cancer in high risk group of ADC value diagnosis at the same time. Results there were 543 effective ROI, 224 ROI, 276 ROI in benign prostatic hyperplasia and 43 ROI in normal prostate tissues in 89 cases of benign prostatic diseases. There was significant difference in ADC value between prostate cancer focus and noncancerous lesion corresponding to ROI. There was significant difference in ADC value between prostate cancer group, prostate hyperplasia group and normal tissue group, there was significant difference between prostate cancer group, prostate hyperplasia group and normal tissue group, and there was significant difference between prostate cancer group and prostate hyperplasia group (P 0.01), and there was no significant difference between prostate cancer group and prostate hyperplasia group. There was significant difference in ADC value between normal group (P 0.05) and normal tissue (P 0.05). According to ROC curve analysis, the diagnostic specificity and sensitivity of prostate cancer were higher when truncation value was less than 1.08 脳 10~(-3)mm~2/s. 84.8% and 95.9%, respectively, which can obtain higher diagnostic efficiency. There was a negative correlation between ADC value and Gleason score in prostate cancer, there was significant difference in ADC value between Gleason score group and ADC score group. There was significant difference in ADC value between multiple comparison Gleason score group and 7 group and 8 score group with 9 group. There was significant difference in ADC value between Gleason score group and Gleason score group (P < 0.01), and there was significant difference in ADC value between Gleason score group (P < 0.05) and Gleason score group (P < 0.05). There was a significant difference in ADC value between Gleason score group and Gleason score group (P < 0.05). There was no significant difference in ADC values among the groups with scores of 7, 8 and 9. When the truncation value of ROC curve was less than 0.997 脳 10~(-3)mm~2/s, there was no statistical difference between the two groups (P < 0.05). The specificity and sensitivity of Gleason score 鈮，

本文編號(hào)：1901548