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目的探讨磁共振扩散加权成像(DWI)对前列腺疾病的诊断价值及其评价前列腺癌肿瘤细胞增殖状况的可行性。方法对15例正常志愿者和35例经病理证实的前列腺疾病患者行MRI常规平扫及DWI检查,分析各组间ADC值,并行ROC曲线分析,得出前列腺癌的最佳诊断临界点。并对20例前列腺癌患者行HE及免疫组化染色。分析前列腺癌ADC值与细胞密度及Ki-67表达的相关性。结果各组间ADC值从小到大依次为前列腺癌肿组0.94±0.26、增生组1.27±0.22、前列腺癌非癌外周带1.46±0.37及正常外周带1.62±0.26,(F=78.36,P=0.000);当ADC值为1.13时对前列腺外周带癌诊断的敏感性、特异性及曲线下面积分别为86﹪、83﹪及89.9﹪。前列腺癌肿组ADC值与细胞密度、Ki-67表达具有较明显的相关性(P分别为0.001、0.021)。结论 DWI对前列腺癌有较好的诊断价值,并可较好的评价前列腺癌的肿瘤细胞增殖状况。
Objective To investigate the diagnostic value of diffusion weighted imaging (DWI) in prostate disease and its feasibility in evaluating the proliferation of prostate cancer cells. Methods 15 cases of normal volunteers and 35 cases of pathologically confirmed prostate disease patients underwent routine MRI plain scan and DWI examination, analysis of ADC values between groups, parallel ROC curve analysis, the best diagnostic threshold for prostate cancer. And 20 cases of prostate cancer patients underwent HE and immunohistochemical staining. The correlation between ADC value and cell density and Ki-67 expression in prostate cancer was analyzed. Results The ADC value of each group was 0.94 ± 0.26 in prostate cancer group, 1.27 ± 0.22 in proliferative group, 1.46 ± 0.37 in non-cancerous peripheral region of prostate cancer and 1.62 ± 0.26 in normal peripheral region (F = 78.36, P = 0.000 ). The sensitivity, specificity and area under the curve for the diagnosis of peripheral prostate cancer with ADC value of 1.13 were 86%, 83% and 89.9% respectively. There was a significant correlation between ADC value and cell density and Ki-67 expression in prostate cancer group (P = 0.001 and 0.021, respectively). Conclusion DWI has a good diagnostic value for prostate cancer, and can be a good evaluation of prostate cancer cell proliferation.