Page 125 - 磁共振成像2024年7期电子刊

临床研究｜｜Clinical Articles 磁共振成像 2024年7月第15卷第7期 Chin J Magn Reson Imaging, Jul, 2024, Vol. 15, No. 7

体素内不相干运动联合表观扩散系数对前列腺癌

诊断价值的研究

1
1*
1
1
2
1
1
陈炤庭 ，邹玉坚 ，袁灼彬 ，王朝阳 ，黄小兰 ，张坤林 ，陈祐君 ，梁桂锋 2
作者单位 1. 南方医科大学第十附属医院（东莞市人民医院）放射科，东莞 523059；2. 南方医科大学第十附属医院（东莞市人民医
院）泌尿外科，东莞 523059
* 通信作者 邹玉坚，E-mail: zouyujian@sohu.com
中图分类号 R445.2；R737.25 文献标识码 A DOI 10.12015/issn.1674-8034.2024.07.020
本文引用格式 陈炤庭, 邹玉坚, 袁灼彬, 等 . 体素内不相干运动联合表观扩散系数对前列腺癌诊断价值的研究[J]. 磁共振成像,
2024, 15(7): 118-123, 142.
[摘要] 目的 探讨体素内不相干运动（intravoxel incoherent motion, IVIM）定量参数联合表观扩散系数（apparent diffusion
coefficient, ADC） 对前列腺癌 （prostate cancer, PCa） 的诊断价值。材料与方法 收集本院行前列腺多参数磁共振成像
（multiparametric MRI, mpMRI） 检查患者 74 例，其中 PCa 41 例 （外周带 PCa 28 例，移行带 PCa 13 例），良性前列腺增生
（benign prostatic hyperplasia, BPH）33 例。采用双指数模型拟合算法获得真实扩散系数（true diffusion coefficient, D）、伪扩散系
*
数（pseudo-diffusion coefficient, D ）、灌注分数（perfusion fraction, f）、ADC 值等定量参数。比较 PCa 与前列腺 T2WI 低信号、
*
高信号增生结节的 D 值、D 值、f值、ADC 值差异。采用受试者工作特征（receiver operating characteristic, ROC）曲线及曲线下
面积（area under the curve, AUC）评价IVIM定量参数联合ADC对PCa的诊断效能。分析IVIM各定量参数、ADC与Gleason评分
的相关性。结果 PCa的ADC值、D值及f值低于T2WI低信号、高信号增生结节，差异有统计学意义（P<0.05）。D值在鉴别PCa
与前列腺 T2WI低信号增生结节中的 AUC最大，特异度最高，差异具有统计学意义（P<0.05）。联合 ADC值、D 值、f值在鉴别
PCa与T2WI低信号增生结节中的AUC、敏感度显著提高（分别为0.948、90.24%）。ADC值在鉴别PCa与T2WI高信号增生结节
中的AUC、敏感度、特异度均非常高（分别为0.997、97.65%、100.00%）。ADC值、IVIM各定量参数与Gleason评分无显著相关
性（P=0.068、0.455、0.822、0.297）。结论 IVIM定量参数联合ADC可显著提高对PCa与BPH的鉴别诊断效能。
[关键词] 前列腺癌；前列腺增生；磁共振成像；体素内不相干运动；表观扩散系数；鉴别诊断

Study on the value of combining intravoxel incoherent motion with apparent diffusion coefficient
in the diagnosis of prostate cancer

1
1
2
1
CHEN Zhaoting , ZOU Yujian , YUAN Zhuobin , WANG Chaoyang , HUANG Xiaolan , ZHANG Kunlin , CHEN Youjun ,
1*
1
1
LIANG Guifeng 2
1 Department of Radiology, the Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Dongguan
523059, China; Department of Urology, the Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital),
2
Dongguan 523059, China
* Correspondence to ZOU Y J, E-mail: zouyujian@sohu.com
Received 15 Mar 2024, Accepted 11 Jun 2024; DOI 10.12015/issn.1674-8034.2024.07.020
ACKNOWLEDGMENTS Dongguan City Social Science and Technology Development Project (No. 20231800904442).
Cite this article as CHEN Z T, ZOU Y J, YUAN Z B, et al. Study on the value of combining intravoxel incoherent motion with apparent
diffusion coefficient in the diagnosis of prostate cancer[J]. Chin J Magn Reson Imaging, 2024, 15(7): 118-123, 142.
Abstract Objective: To explore the diagnostic value of combining quantitative parameters of intravoxel incoherent motion (IVIM)
with apparent diffusion coefficient (ADC) for prostate cancer (PCa). Materials and Methods: Seventy-four cases underwent
multiparametric magnetic resonance (mpMRI) prostate examination, including 41 cases of PCa (28 cases in the peripheral zone, 13 cases
in the transitional zone) and 33 cases of benign prostatic hyperplasia (BPH). Quantitative parameters including true diffusion coefficient
*
(D), pseudo-diffusion coefficient (D ), perfusion fraction (f), and ADC value were obtained by using a bi-exponential model fitting
*
algorithm. The differences in D value, D value, f value and ADC value were compared between PCa and prostate hyperplastic nodule
with hypointense and hyperintense in T2WI. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy
of combining IVIM quantitative parameters with ADC for PCa. The correlation of each quantitative parameter of IVIM and ADC with
the Gleason score was analyzed. Results: The ADC, D, and f values of PCa were significantly lower than those of hyperplastic nodule
with hypointense and hyperintense in T2WI, with statistically significant differences (P<0.05). D value had the largest area under the
curve (AUC) and the highest specificity in distinguishing PCa from prostate hyperplastic nodule with hypointense in T2WI, with
statistically significant differences (P<0.05). The combination of ADC, D and f values significantly increased the AUC and sensitivity
between PCa and hyperplastic nodule with hypointense in T2WI (0.948, 90.24% respectively). ADC value showed very high AUC,
sensitivity and specificity for distinguishing PCa from prostate hyperplastic nodule with hyperintense in T2WI (0.997, 97.65%, 100.00%
respectively). There was no significant correlation between ADC value, each quantitative parameter of IVIM and the Gleason score (P=
0.068, 0.455, 0.822, 0.297). Conclusions: The quantitative parameters of IVIM combined with ADC can obviously improve the
differential diagnostic efficacy for PCa and BPH.
Key words prostate cancer; prostate hyperplasia; magnetic resonance imaging; intravoxel incoherent motion; apparent diffusion
coefficient; differential diagnosis

收稿日期 2024-03-15 接受日期 2024-06-11
基金项目 东莞市社会科技发展项目（编号：20231800904442）

·118 · https://www.chinesemri.com