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目的探讨(胆碱+肌酸)/枸橼酸盐(CC/C)值和表观扩散系数(ADC)值及联合应用两者对中央腺体癌的诊断效能。方法回顾性分析经病理证实的前列腺中央腺体癌27例,良性中央腺体病变62例,比较两者的平均CC/C值和ADC值(采用3种测量方法分别获得最小ADC值、平均ADC1和平均ADC2);通过判别分析计算平均CC/C值和ADC值诊断中央腺体癌时各自所占的权重;采用受试者工作特征曲线分析计算平均CC/C值、3种ADC值及联合CC/C值和ADC值对中央腺体癌的诊断效能。结果 (1)前列腺中央腺体癌组和良性中央腺体病变的平均CC/C值、最小ADC值、平均ADC1和平均ADC2比较差异均有统计学意义(t=3.582、-9.416、-9.716、-9.889,P<0.05);(2)3种ADC值诊断中央腺体癌的权重均高于平均CC/C值;(3)3种ADC值、分别联合平均CC/C值和3种ADC值诊断中央腺体癌的曲线下面积(AUC)显著高于平均CC/C值,差异均有统计学意义(P<0.05);3种ADC值、分别联合平均CC/C值和3种ADC值诊断中央腺体癌的AUC差异均无统计学意义(P>0.05);3种ADC值诊断中央腺体癌的AUC差异无统计学意义(P>0.05)。结论 DWI对中央腺体癌的诊断效能优于MRS;不同方法所测得的ADC值对中央腺体癌的诊断效能无差异;联合DWI和MRS对中央腺体良恶性病变的鉴别优于MRS。
Objective To investigate the diagnostic efficacy of (choline + creatine) / citrate (CC / C) values and apparent diffusion coefficient (ADC) values and their combination in the diagnosis of central gland carcinoma. Methods Retrospective analysis of pathologically confirmed central prostate cancer in 27 cases, 62 cases of benign central gland lesions, the average CC / C and ADC values were compared (using three kinds of measurement methods were the smallest ADC value, the average ADC1 And average ADC2); Calculate the average CC / C value and ADC value of the diagnosis of central gland cancer by discriminant analysis of the respective weight; using the receiver operating characteristic curve analysis of the average CC / C value, the three ADC values and the combination Diagnostic efficacy of CC / C values and ADC values for central gland carcinoma. Results (1) The average CC / C value, minimum ADC value, average ADC1 and average ADC2 in prostate cancer group and benign central gland disease were significantly different (t = 3.582, -9.416, -9.716, -9.889, P <0.05). (2) The weights of three kinds of ADCs in diagnosis of central gland carcinoma were higher than the average CC / C values. (3) The three kinds of ADC values were combined with the average CC / The area under the curve (AUC) was significantly higher than that of the average CC / C in the diagnosis of central gland carcinoma (P <0.05). The ADC values of three ADCs were respectively combined with the average CC / There was no significant difference in the AUC values of central gland carcinoma (P> 0.05). There was no significant difference in AUC between the three ADC values (P> 0.05). Conclusion DWI is superior to MRS in diagnosing central gland carcinoma. The ADC values measured by different methods have no difference in diagnosis of central gland carcinoma. The combination of DWI and MRS is superior to MRS in distinguishing benign and malignant lesions of central gland.