T磁共振DTI联合MRS对前列腺癌诊断价值的研究-第三军医大学学报.DOC

DTI联合3D-1H-MRS对前列腺癌诊断效能的研究 周红俐，赵建农 ，郭大静，罗银灯，何晓静，吴伟，周治明，王晚千，吴媛 （400010 重庆，重庆医科大学附属第二医院放射科） [摘要] 目的 探讨3T MRI扩散张量成像(diffusion tensor imaging, DTI)联合波谱成像( MR spectroscopy，MRS)用于前列腺癌的诊断价值。 方法 45例临床高度可疑的前列腺癌患者同时行DTI、MRS检查，与病检结果对照，分析癌区和非癌区的平均表观扩散系数值(ADC)、各向异性分数值(FA)、(胆碱+肌酐)/枸橼酸盐值(CC/C)的差异。通过逻辑回归构建诊断模型，对比分析ADC、FA、DTI、MRS、DTI+MRS诊断前列腺癌的ROC曲线下面积（the area under the ROC curve,AUC），计算DTI、MRS、“DTI和MRS”、“DTI或MRS”的敏感度、特异度、阳性预测值、阴性预测值。 结果 38例患者顺利通过检查并获得可分析图像。无论外周带或中央区，癌区的ADC值均显著低于非癌区(P＜0.01)，癌区的FA、CC/C值均显著高于非癌区(P＜0.01，P＜0.05)。在外周带，DTI+MRS的AUC显著高于单独应用DTI、MRS（P＜0.01）；在中央区，DTI+MRS的AUC显著高于DTI(P＜0.01），与MRS无显著差异（P＞0.05）。“DTI和MRS”在外周带及中央区均获得最高特异度，显著高于单独的DTI、MRS(P＜0.05)；“DTI 或MRS”获得最高敏感度，在外周带显著高于单独的MRS(P＜0.01)，在中央区显著高于单独的DTI(P＜0.01)。结论 DTI联合MRS较单独DTI、MRS更有助于前列腺癌的诊断。 [关键词] 前列腺癌；扩散张量成像；波谱成像；联合 Study on the diagnostic value of combined use of DTI and 3D-1H-MRS for prostate cancer Zhou Hongli，Zhao Jiannong，Guo Dajing，Luo Yindeng，He Xiaojing，Wu Wei，Zhou Zhiming，Wan Wanqian，Wu Yuan (Department of radiology，Second Affiliated Hospital，Chongqing Medical University，Chongqing，400010，China) Objective To evaluate the combination of duffusion tensor imaging(DTI) and MR spectroscopy(MRS) for the diagnosis of prostate cancer. Methods 45 patients with clinical suspicion of prostate cancer underwent DTI and MRS, MRI data were correlated to pathology results. The average values of apparent diffusion coefficients(ADC), fractional anisotropy(FA) and (Choline+Creatinine)/Citrate(CC/C) in cancerous and noncancerous regions were meaured. Logistic regression were used to construct diagnostic models，the areas under the curve (AUC) were compared between ADC，FA，DTI，MRS，DTI+MRS. Calculate the sensitivity, specificitypositive predictive value, negative predictive value of DTI，MRS，“DTI and MRS”，“DTI or MRS”.Results 38 patients acquired images that can be analysed. Whether in peripheral zone(PZ) or central zone(CZ)，the ADC value of cancerous regions was significantly lower tha