Roy C, Pasquali R, Matau A, Bazille G, Lang H
Service de Radiologie B, Hopitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, 1 Place de l'Hôpital, BP 426, 67091 Strasbourg Cedex.
J Radiol. 2010 Nov;91(11 Pt 1):1121-8. doi: 10.1016/s0221-0363(10)70157-8.
Evaluate diffusion MRI in the multiparametric assessment of prostate cancer before needle biopsy.
One hundred eleven patients with suspected prostate cancer (mean age: 63 years old, median PSA: 7 ng/mL) were examined before undergoing needle biopsy (59 patients with a history of a negative biopsy and 52 without a history of biopsy). A diffusion sequence type SS SE-EPI (TR/TE: 5357/58, fEPI: 73, b 0 and 1000 s/mm², axial) with a qualitative analysis of the ADC map was performed in addition to T2 and T1 gadolinium enhanced sequences on 3 T MRI with an endorectal coil. The histological correlations were obtained by ultrasound guided needle biopsy (85 patients) or radical prostatectomy (26 patients).
The correlation of the results of the diffusion sequence in the series of the 111 patients and the biopsies of the entire prostate or the hemiprostate had a sensitivity of: 92%, 77%; a specificity of: 55%, 70%; a positive predictive value of: 77%, 62%; a negative predictive value of: 84%, 80% and an efficacy of 78%, 75% respectively. The agreement of the three sequences had a specificity of 84.3%.
The sensitivity of diffusion MRI is high for the detection of cancer of the prostate. Specificity of sequences is good. The results of simple visual assessment of the ADC map are good.
评估磁共振扩散成像在前列腺癌穿刺活检前多参数评估中的应用价值。
111例疑似前列腺癌患者（平均年龄63岁，前列腺特异抗原中位数为7 ng/mL）在接受穿刺活检前接受检查（59例有活检阴性史，52例无活检史）。除了在3T磁共振成像上使用直肠内线圈进行T2加权成像和T1加权钆增强成像序列外，还采用了SS SE-EPI扩散序列（TR/TE：5357/58，回波平面成像因子：73，b值为0和1000 s/mm²，轴位），并对表观扩散系数图进行定性分析。通过超声引导下穿刺活检（85例）或根治性前列腺切除术（26例）获得组织学相关性结果。
在111例患者系列中，扩散序列结果与整个前列腺或半侧前列腺活检结果的相关性为：敏感性分别为92%、77%；特异性分别为55%、70%；阳性预测值分别为77%、62%；阴性预测值分别为84%、80%；效能分别为78%、75%。三种序列的一致性特异性为84.3%。
磁共振扩散成像对前列腺癌的检测具有较高的敏感性。序列特异性良好。对表观扩散系数图进行简单视觉评估的结果较好。
