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目的探讨磁共振扩散张量成像(DTI)技术对前列腺癌(PCa)病理分级的诊断价值。方法回顾性分析经穿刺活检或手术病理证实的50例PCa患者资料,均行常规MRI、DTI扫描。根据Gleason评分分为低级别组、中级别组和高级别组。运用Neuro 3D软件测量PCa组织的各向异性分数(FA)值、表观扩散系数(ADC)值和绘制扩散张量纤维束成像(DTT)图,采用ANOVA分析研究不同级别组PCa的FA值和ADC值差异,采用Pearson相关性研究不同级别组FA值和ADC值与Gleason分级的相关性。结果 DTT图很好地显示了PCa癌区纤维束走行、排列特点,低级别组癌灶区纤维束排列稠密、无中断;中级别组癌灶区纤维束排列紊乱、稀疏;高级别组癌灶区纤维束中断、缺失。低级别组、中级别组、高级别组FA值分别为0.284±0.313、0.293±0.347、0.369±0.347,各组间差异均具有统计学意义(F=234.533,P<0.05),两两比较均具有统计学差异(P<0.05),FA值与Gleason评分呈正相关(r=0.884,P<0.05);ADC值分别为(1.070±0.072)×10~(-3)mm~2/s、(0.961±0.081)×10~(-3)mm~2/s、(0.821±0.048)×10~(-3)mm~2/s,各组间差异均具有统计学意义(F=49.987,P<0.05),两两比较均具有统计学差异(P<0.05),ADC值与Gleason评分呈负相关(r=-0.810,P<0.05)。结论 DTI可用于评估PCa的病理分级和预后。FA值与Gleason评分呈正相关,ADC值与Gleason评分呈负相关。DTT图显示不同级别PCa癌灶区纤维束差异更为直观。
Objective To investigate the diagnostic value of magnetic resonance diffusion tensor imaging (DTI) in the pathological classification of prostate cancer (PCa). Methods The data of 50 PCa patients confirmed by biopsy or surgical pathology were retrospectively analyzed. Both routine MRI and DTI scan were performed. According to Gleason score is divided into low-level group, middle-level group and high-level group. The FA value, apparent diffusion coefficient (ADC) value and diffusion tensor fiber bundle imaging (DTT) of PCa tissue were measured by Neuro 3D software. The ANOVA analysis was used to study the FA value of PCa and ADC value differences, Pearson correlation study of different levels of FA value and ADC value and Gleason grade correlation. RESULTS: The DTT pattern showed that the fiber bundles in PCa were well arranged and arranged. The fiber bundles in the low-grade group were densely arranged without disruption. The fiber bundles in the middle-grade group were disordered and sparse. The high-grade group District fiber bundle interrupted, missing. FA values of low-grade group, middle-grade group and high-grade group were 0.284 ± 0.313,0.293 ± 0.347,0.369 ± 0.347 respectively, and there were significant differences among the groups (F = 234.533, P <0.05) (P <0.05). There was a positive correlation between FA and Gleason score (r = 0.884, P <0.05). The ADC values were 1.070 ± 0.072 × 10 -3 mm 2 / s, 0.961 ± 0.081) × 10 ~ (-3) mm ~ 2 / s and (0.821 ± 0.048) × 10 ~ (-3) mm ~ 2 / s respectively.The differences among the groups were statistically significant (F = 49.987, P (P <0.05). There was a negative correlation between ADC value and Gleason score (r = -0.810, P <0.05). Conclusion DTI can be used to evaluate the pathological grade and prognosis of PCa. FA value was positively correlated with Gleason score, and ADC value was negatively correlated with Gleason score. The DTT images showed that the differences of fiber bundles in different grades of PCa foci were more intuitive.