多b值、ADC和动态增强定量参数在前列腺周围带癌诊断中的价值

The Value of Multiple b Values, the ADC and Dynamic Enhanced Semi-Quantitative Parameter in the Diagnosis of Prostate Cancer in the Surrounding Zone

摘要: 目的：评估扩散加权成像(DWI)多b值、平均表观扩散系数(aADC)和动态增强定量参数的最大相对强化率(MRE)、曲线下面积(AUC)在前列腺周围带癌诊断的价值。方法：前列腺周围带癌30例，前列腺周围带炎症20例，前列腺周围带正常15例。多b值为0 s/mm²、400 s/mm²、800 s/mm²，aADC值取b = 800 s/mm²测定。统计学处理：组间两两比较和各组间两两比较采用方差检验，癌症组、炎症组和正常组合并后(aADC)和MRE、AUC三者之间关系，p < 0.05差异均有统计学意义。结果：癌症组多b值示随b值增高，癌灶信号强度随之增高，aADC阈值小于1 × 10⁻³ mm²/s。aADC的癌症组、炎症组和正常组组间两两比较组间F值 = 254.989，p < 0.001，MRE的癌症组、炎症组和正常组组间两两比较组间F值 = 9.568，p < 0.001，AUC的癌症组、炎症组和正常组组间两两比较组间F值 = 19.706，p < 0.001。三组合并后，aADC和MRE、AUC三者之间关系p < 0.001有统计学意义。结论：DWI多b值对周围带病灶检出和定性诊断有意义；癌灶aADC值低于非癌组织，癌灶MRE和AUC高于非癌组织，DWI多b值、aADC、MRE和AUC联合应用在前列腺周围带癌诊断中具有重要临床适用价值。

Abstract: Objective: To evaluate the value of the diffusion weighted imaging (DWI) multi b-value, the average apparent diffusion coefficient (aADC) and dynamic enhanced semi quantitative parameters of maximum relative enhancement ratio (MRE), and the area under the curve (AUC) with a cancer diagnosis in peripheral zone. Methods: The peripheral zone of prostate cancer in 30 cases, the peripheral zone of prostate inflammation in 20 cases, and the peripheral zone of normal in 15 cases. Multi b-values are 0 s/mm², 400 s/mm², 800 s/mm², the value of aADC was measured by b = 800 s/mm². One-way ANOVA was applied to analyze the quantitative data. Pearson correlation analysis was used to evaluate the correlation between the parameters of aADC, MRE and AUC. Results: multiple b values of Cancer group were shown with b value increased, along with tumor signal intensity increased, and the threshold of aADC was less than 1 × 10⁻³ mm²/s. The differences of aADC, MRE and AUC between cancer group, inflammatory group and normal group were statistically significant (p < 0.001). After three groups’ combination, the relationship between three of aADC and MRE, AUC, p < 0.001 has statistically significance. Conclusion: DWI b value has significant impact on the peripheral zone lesions detection and diagnosis, tumor aADC value is lower than the non cancer tissue, tumor MRE and AUC are higher than non cancer tissues. The combined application of DWI multi b-value, MRE and AUC in the peripheral zone of prostate cancer has important clinical application value in diagnosis.