| 李鹏,杨文君,陈志强,郭玉林,蔡磊,杨文静,李燕.T2WI和DWI联合血清前列腺特异抗原系列诊断前列腺癌[J].中国医学影像技术,2013,29(4):612~616 |
| T2WI和DWI联合血清前列腺特异抗原系列诊断前列腺癌 |
| T2WI and DWI combined with serum prostate specific antigen series in diagnosis of prostate cancer |
| 投稿时间：2012-09-25 修订日期：2012-11-25 |
| DOI： |
| 中文关键词: 前列腺肿瘤 前列腺增生 前列腺特异抗原 磁共振成像 扩散磁共振成像 |
| 英文关键词:Prostatic neoplasms Prostatic hyperplasia Prostate-specific antigen Magnetic resonance imaging Diffusion magnetic resonance imaging |
| 基金项目:宁夏自然科学基金资助项目(NZ09110);宁夏自然科学基金资助项目(NZ1234)。 |
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| 中文摘要: |
| 目的 探讨T2WI+DWI联合血清前列腺特异抗原(PSA)系列对前列腺癌(PCa)的诊断价值。方法 回顾性分析经病理证实的50例PCa(阳性组)、50例前列腺增生(BPH)和10例BPH合并慢性前列腺炎(CP)患者(阴性组)的MRI、DWI资料和总PSA(tPSA)、游离PSA(fPSA)与tPSA的比值(f/tPSA)、前列腺特异抗原密度(PSAD)检测结果,比较T2WI+DWI及T2WI+DWI分别联合tPSA、f/tPSA、PSAD诊断PCa的敏感度、特异度和准确率,通过ROC曲线下面积(AUC)值比较每种方法的诊断效能。结果 阳性组和阴性组间tPSA、f/tPSA、PSAD差异均有统计学意义(t=10.10、-4.52、14.41,P均<0.01);T2WI+DWI诊断PCa的敏感度、特异度、准确率和AUC分别为92.00%、71.67%、80.91%和0.818,95%可信区间为0.752~0.885;以tPSA>10 ng/ml、f/tPSA≤0.15、PSAD≥0.22 ng/(ml·cm3)为诊断PCa的界值,T2WI+DWI分别联合tPSA、f/tPSA、PSAD诊断PCa的特异度、准确率和AUC均明显提高。T2WI+DWI联合PSAD诊断PCa的效能最好,其敏感度、特异度、准确率和AUC分别为88.00%、90.00%、89.09%和0.890,95%可信区间为0.829~0.951。结论 T2WI+DWI联合tPSA、f/tPSA、PSAD能够明显提高对PCa的诊断效能。 |
| 英文摘要: |
| Objective To investigate the value of T2WI+DWI combined with serum prostate specific antigen (PSA) series in diagnosis of prostate cancer (PCa). Methods Fifty patients with PCa (positive group), 50 with benign prostate hyperplasia (BPH) and 10 with BPH and chronic prostatitis (negative group) proved by pathology who underwent conventional MRI, DWI examination were enrolled, and all of them had PSA data (including total PSA, ratio of free PSA to tPSA, PSA density ). The diagnostic sensitivity, specificity and accuracy of T2WI+DWI and T2WI+DWI combined with tPSA, f/tPSA, PSAD were compared. The area under ROC curve (AUC) of each method was evaluated. Results The mean value of tPSA, f/tPSA, PSAD in the two groups were statistically different (t=10.10,-4.52, 14.41, all P<0.01). The sensitivity, specificity, accuracy and AUC of T2WI+DWI was 92.00%, 71.67%, 80.91% and 0.818, respectively, and 95% confidence interval was 0.752-0.885. Taking tPSA>10 ng/ml, f/tPSA≤0.15, PSAD≥0.22 ng/(ml·cm3) as diagnosis standards of PCa, the specificity, accuracy and AUC of combination of T2WI+DWI and tPSA, f/tPSA, PSAD respectively were all significantly improved. The diagnostic value of T2WI+DWI+PSAD was the best, the sensitivity, specificity, accuracy and AUC was 88.00%, 90.00%, 89.09% and 0.890, 95% confidence interval was 0.829-0.951. Conclusion T2WI+DWI combined with tPSA, f/tPSA, PSAD respectively can improve the diagnosis accuracy of PCa. |
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