多参数MRI评估前列腺癌主要病灶体积的价值

Value of multiparametric MRI sequences in evaluating the index lesion volume of prostate cancer

关键词:  前列腺癌  磁共振成像  诊断  病理  对照研究

Key words:  prostate cancer  magnetic resonance imaging  diagnosis  pathology  comparative study

摘要:

目的探讨多参数MRI（multiparametric MRI， Mp-MRI）各序列评估前列腺癌（prostate cancer， PCa）主要病灶体积的价值。方法回顾性分析同济大学附属同济医院2017年1月至—2018年6月经病理证实的56例PCa病例MRI资料。依据PCa主要病灶动态对比增强（dynamic contrast enhanced， DCE）表现，将病例分为DCE阳性组和DCE阴性组，分别测量T2WI、ADC图和/或DCE最大面积早期强化图上主要病灶的体积，并与病理病灶体积对比分析。结果DCE阳性组： T2WI、ADC、DCE病灶测量体积与病理均呈正相关，三者均低估了病理体积，低估百分比分别为（41.65±16.66）%、（50.05%±15.81）%、（16.00±14.50）%，DCE的低估百分比低于T2WI及ADC（P<0.001）。DCE阴性组： T2WI、ADC病灶测量体积与病理均呈正相关，相关系数分别为0.95、0.90，二者均低估了病理体积，低估百分比分别为（36.25±14.07）%、（49.87±13.73）%，T2WI低估百分比低于ADC（P<0.001）。结论Mp-MRI各序列均低估了PCa主要病灶体积，病灶DCE阳性时，DCE更有利于评价PCa病灶的体积，而DCE阴性时，T2WI优于DWI。

Abstract:

ObjectiveTo investigate the value of multi-parameter MRI（Mp-MRI) sequences in evaluating the volume of prostate cancer（PCa). MethodsThe MRI data of 56 patients with PCa confirmed by pathology admitted in Tongji Hospital of Tongji University from January 2017 to June 2018 were retrospectively analyzed. According to the dynamic contrast enhanced（DCE) manifestations of the index lesions of PCa, the cases were divided into DCE positive group and DCE negative group. The volume of the index lesions on T2WI, ADC and/or DCE maximum area early enhanced images were measured and compared with the pathological lesions. ResultsIn DCE positive group, the measured volume of T2WI, ADC and DCE were positively correlated with pathological volume. The three sequences all underestimated the pathological volume, with the underestimation percentage of（41.65±16.66）%，（50.05%±15.81）% and （16.00±14.50）%, respectively. The underestimation percentage of DCE was lower than that of T2WI and ADC（P<0.001). In DCE negative group, the measured volume of T2WI and ADC were positively correlated with pathological volume, with correlation coefficients of 0.95 and 0.90 respectively. Both of them underestimated the pathological volume by（36.25±14.07）% and （49.87±13.73）%, respectively. The underestimation percentage of T2WI was lower than that of ADC（P<0.001). ConclusionEach sequence of Mp-MRI underestimates the index lesions volume of PCa. DCE was more helpful to evaluate the volume of PCa lesions when DCE is positive, while T2WI was better than DWI when DCE is negative.