| 姚楠.MRI多参数成像(mp-MRI)定量参数值对外周带前列腺癌侵袭性的研究[J].中国医学影像技术,2020,36(6): |
| MRI多参数成像(mp-MRI)定量参数值对外周带前列腺癌侵袭性的研究 |
| Invasiveness of quantitative parameters of multi-parameter imaging (mp-MRI) in peripheral prostate cancer |
| 投稿时间：2019-10-11 修订日期：2020-06-14 |
| DOI： |
| 中文关键词: 前列腺，腺癌，侵袭性，多参数MRI |
| 英文关键词:prostate,adenocarcinoma,aggressiveness,multi-parametric MRI |
| 基金项目:无 |
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| 摘要点击次数: 1435 |
| 全文下载次数: 619 |
| 中文摘要: |
| 目的：探讨mp-MRI定量参数值对外周带前列腺癌侵袭性的临床价值。方法：(1)对临床疑诊前列腺癌且符合纳入标准的病人行前列腺MRI多参数扫描。(2)利用图像后处理软件Intellispace Portal对扫描图像进行后处理,得到多参数定量参数伪彩图,并分别测量肿瘤组织的定量参数值。(3)依据病理ISUP分级将组织分为ISUP＜3级和ISUP≥3级。(4)采用检验对ISUP＜3级与ISUP≥3级组间前列腺癌mp-MRI参数值进行统计分析,以＜0.05为诊断效能,对分析结果差异具有统计学意义的指标行多因素logistic回归分析,并建立回归方程,并运用受试者工作特征曲线评估独立预测因子及其联合指标预测前列腺癌ISUP＜3级与ISUP≥3级组间的诊断效能。结果：(1)69份前列腺癌组织在mp-MRI多参数图上表现为外周带结节或肿块,T2WI呈低信号,DWI弥散受限呈高信号,动态对比增强DCE图像早期强化。(2)69份前列腺癌组织病理分级：ISUP＜3级组织27份,ISUP≥3级组织42份。(3)ISUP＜3级与ISUP≥3级两组间的ADC值及Ktrans值差异具有统计学意义(＜0.001、=0.013)。(4)前列腺癌mp-MRI定量参数值logistics回归分析结果显示：ADC值(95%置信区间：-2.2178～-0.8856,相关系数-1.55171)及Ktrans值(95%置信区间：0.0004～0.0222,相关系数0.011323)可以作为区分ISUP＜3级与ISUP≥3级的独立预测指标。(5)独立预测因子及联合指标对前列腺癌ISUP＜3级与ISUP≥3级的诊断效能：ADC的截断值0.55mm2/s,准确度0.739(曲线下面积0.807,灵敏度0.800,特异度0.714)；Ktrans的截断值80.77×10-3/min,准确度0.594(曲线下面积0.690,灵敏度0.850,特异度0.490)；两者的联合指标的截断值0.2901,准确度0.754(曲线下面积0.810,灵敏度0.900,特异度0.653)。结论：Mp-MRI中的ADC值及Ktrans值可作为前列腺癌侵袭性判断的独立预测因子,二者联合诊断效能更佳。 |
| 英文摘要: |
| Objectives: Clinical value of quantitative parameters of mp-MRI in aggressiveness of peripheral prostate cancer. Methods:(1)Prostate mp-MRI scanning was performed for clinically suspected prostate cancer patients who met the inclusion criteria. (2) Intellispace Portal software was used to post-process the scanning images, and mp-MRI quantitative pseudo-color maps were obtained. The parameters were measured, respectively. (3)The tissues were divided into ISUP<3 and ISUP ≥ 3 groups according to pathological ISUP grade. (4) The parameters of mp-MRI in prostate cancer between ISUP<3 and ISUP ≥ 3 goups were statistically analyzed by independent t-test. Taking p <0. 05 as diagnostic efficacy, the independent predictors were identified and their combination were built by multivariate logistic regression analysis. The diagnostic efficacy between ISUP<3 and ISUP ≥ 3 groups was evaluated by using the receiver operating characteristic curve(AUC), sensitivity, specificity and accuracy. Results：(1)69 prostate cancer tissues showed peripheral nodules or masses on mp-MRI multi-parameter map, appearing as hypointense on T2W images, hyperintense on diffusion weighted imaging (DWI) maps and early enhancement on dynamic contrast-enhanced (DCE) images.(2) The pathological grading of 69 cases of prostate cancer: 27 cases of ISUP<3 and 42 cases of ISUP≥3.(3) There were significant differences in ADC and Ktrans values between ISUP<3 and ISUP ≥ 3 groups(P <0.001, P=0.013).(4) In multivariate logistics regression analysis, only ADC (95% CI:-2.2178～- 0.8856,r=-1.55171) and Ktrans (95% CI:0.0004～0.0222,r=0.011323) were the independent predictors to distinguish ISUP<3 from ISUP ≥ 3 groups. (5) For prostate cancer ISUP<3 and ISUP ≥ 3groups ,the cutoff value and the predicted accuracy of ADC、Ktrans and their combination were 0.55mm2/sand 0.739(AUC 0.807;sensitivity 0.800; specificity 0.714);80.77×10-3/min and 0.594 (AUC 0.690;sensitivity 0.850;specificity 0.490);0.2901 and 0.754(AUC 0.810;sensitivity 0.900;specificity 0.653). Conclusions：ADC and Ktrans can be used as independent predictors of prostate aggressiveness, and the combination of ADC and Ktrans is more effective in the diagnosis of prostate cancer. |
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