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目的探讨超高b值扩散加权成像(DWI)鉴别前列腺中央腺体良恶性结节的临床价值。方法经穿刺活检证实的28例前列腺中央腺体癌和22例前列腺增生结节行磁共振常规扫描和DWI(b=1000,2000 s/mm2)检查。由两名泌尿系统MR诊断医师分别测定前列腺结节的表观扩散系数(ADC)值,比较不同b值下良恶性结节ADC值的差异,并以受试者工作特征(ROC)曲线评估ADC诊断阈值。结果 b=1000 s/mm2时前列腺腺体增生为主结节、间质增生为主结节和中央腺体癌的平均ADC值(×10-3mm2/s)分别为1.71±0.48、1.27±0.23和1.12±0.17,中央腺体癌与间质增生结节无显著差异(P>0.05),与腺体增生为主结节具有显著差异(P<0.05);b=2000 s/mm2时前列腺腺体增生为主结节、间质增生为主结节和中央腺体癌的平均ADC值(×10-3mm2/s)分别为1.14±0.27、0.87±0.23和0.68±0.16,中央腺体癌与腺体增生为主结节、间质增生为主结节均具有显著差异(P<0.05)。结论超高b值DWI可显著提高磁共振对前列腺中央腺体良恶性结节的鉴别诊断能力。
Objective To investigate the clinical value of ultra-high b-value diffusion-weighted imaging (DWI) in differentiating benign and malignant nodules of central prostatic glands. Methods 28 cases of prostate gland carcinoma and 22 cases of benign prostatic hyperplasia nodules confirmed by biopsy were examined by routine MRI and DWI (b = 1000, 2000 s / mm2). Apparent diffusion coefficient (ADC) of prostatic nodules was determined by two urologists and MR diagnostic physicians respectively. ADC values of benign and malignant nodules at different b-values were compared. The ADCs of ADCs were evaluated by receiver operating characteristic (ROC) Diagnostic threshold. Results The average ADC value (× 10-3mm2 / s) of prostatic gland hyperplasia at the b = 1000 s / mm2 was 1.71 ± 0.48 and 1.27 ± 0.23 And 1.12 ± 0.17 respectively. There was no significant difference between central gland carcinoma and interstitial hyperplastic nodules (P> 0.05), which was significantly different from that of glandular hyperplasia (P <0.05). When b = 2000 s / mm2, The average ADC value (× 10-3mm2 / s) of proliferating nodules and interstitial proliferating nodules and central gland carcinomas were 1.14 ± 0.27, 0.87 ± 0.23 and 0.68 ± 0.16, respectively Gland hyperplasia as the main nodules, interstitial hyperplasia-based nodules were significantly different (P <0.05). Conclusion Ultra-high b-value DWI can significantly improve the differential diagnosis of benign and malignant nodules in the central gland of prostate.