Value of 1.5 T MR DWI in the evaluation of benign and malignant prostate lesions
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摘要:
目的探究前列腺良恶性病变采用1.5 T磁共振扩散加权成像(MR DWI)检查应用价值。 方法对2017年10月~2020年8月我院收治136例前列腺病变患者相关资料进行回顾性分析，患者均接受MR DWI检查。分析DWI对于前列腺良恶性病变诊断价值，比较前列腺良恶性病变患者ADC值、eADC值及其对前列腺良恶性病变诊断价值，比较前列腺良恶性病变患者DWI半定量分级分布情况。 结果以病理检查作为金标准，DWI诊断前列腺恶性病变敏感度、特异性及准确度分别为95.16%、98.65%、97.06%，Kappa值为0.941；恶性病变患者ADC值显著低于良性病变，eADC值显著高于良性病变(P < 0.05)；ROC曲线显示，ADC值、eADC值及两指标联合诊断前列腺良恶性病变ADC值分别为0.902、0.967、0.990；恶性病变患者DWI半定量分级主要为4~5级，良性病变患者DWI半定量分级主要为1~3级，差异有统计学意义(P < 0.05)。 结论1.5 T MR DWI用于评估前列腺良恶性病变价值优异，值得临床推广应用。 Abstract:ObjectiveTo investigate the application value of 1.5 T magnetic resonance diffusion weighted imaging (MR DWI) in evaluating benign and malignant prostate lesions. MethodsThe relevant data of 136 patients with prostate lesions admitted to the hospital from October 2017 to August 2020 were retrospectively analyzed. All patients were subjected to MR DWI examination, and the diagnostic value of DWI in benign and malignant prostate lesions was analyzed. The ADC value, eADC value, and DWI semi-quantitative classification of patients with benign and malignant prostate lesions were compared. ResultsTaking pathological examination as the golden standard, the sensitivity, specificity and accuracy of DWI for diagnosing malignant prostate lesions were 95.16%, 98.65%, and 97.06%, and the Kappa value was 0.941. The ADC value of malignant lesions was significantly lower than that of benign lesions, and the eADC value was significantly higher than that of benign lesions (P < 0.05). ROC curve showed that the AUC values of ADC value, eADC value and combination of the two for diagnosing benign and malignant prostate lesions were 0.902, 0.967, and 0.990, respectively. DWI semi-quantitative classification of patients with malignant lesions was dominated by grade 4-5, which of patients with benign lesions was dominated by grade 1-3 (P < 0.05). Conclusion1.5 T MR DWI is of great value in evaluating benign and malignant prostate lesions. -
Key words:
- MR /
- DWI /
- benign and malignant prostate lesions /
- evaluation value
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图 3 前列腺良恶性病变病理表现（HE染色）
A: 恶性病变; B: 良性病变.
Figure 3. Pathological manifestations of benign and malignant prostate lesions
图 4 ADC值与eADC值对于前列腺良恶性病变诊断价值分析ROC曲线
Figure 4. ROC curves of ADC value and eADC value for diagnosing benign and malignant prostate lesions.
表 1 DWI对于前列腺良恶性病变诊断价值分析
Table 1. Diagnostic value of DWI for benign and malignant prostate lesions
DWI 病理检查 合计 恶性 良性 恶性 59 1 60 良性 3 73 76 合计 62 74 136 
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表 2 前列腺良恶性病变患者ADC值与eADC值比较
Table 2. Comparison of ADC value and eADC value between patients with benign and malignant prostate lesions (Mean±SD)
组别 ADC值(×10-3 mm2/s) eADC值 恶性病变(n=62) 0.97±0.26 0.57±0.15 良性病变(n=74) 1.82±0.38 0.33±0.09 t 16.557 11.515 P < 0.001 < 0.001
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表 3 ADC值与eADC值对于前列腺良恶性病变诊断价值分析
Table 3. Diagnostic value of ADC value and eADC value for benign and malignant prostate lesions
指标 截断值 AUC 敏感度(%) 特异性(%) 95%CI P ADC值 1.25×10-3 mm2/s 0.902 85.3 79.6 0.851~0.952 < 0.001 eADC值 0.46 0.967 94.5 89.5 0.940~0.994 < 0.001 两指标联合 0.990 96.4 92.3 0.977~1.000 < 0.001
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表 4 前列腺良恶性病变患者DWI半定量分级分布情况比较
Table 4. Comparison of DWI semi- quantitative classification of patients with benign and malignant prostate lesions [n(%)]
组别 1~3级 4~5级 恶性病变(n=62) 18(29.03) 44(70.97) 良性病变(n=74) 45(60.81) 29(39.19) t 13.702 P < 0.001
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