Shimamoto Tsutomu, Ashida Shingo, Yamasaki Ichiro, Kuno Takahira, Fukuhara Hideo, Fukata Satoshi, Satake Hirofumi, Tamura Kenji, Karashima Takashi, Kamata Masayuki, Inoue Keiji, Shuin Taro, Kariya Shinji, Ogawa Yasuhiro
The Department of Urology, Kochi Medical School, Japan.
Hinyokika Kiyo. 2012 Mar;58(3):143-8.
Diffusion-weighted imaging (DWI) is a magnetic resonance imaging (MRI) method and is considered potentially useful for detecting prostate cancer. We evaluated the clinical value of DWI with apparent diffusion coefficient (ADC) maps in addition to T2-weighted imaging (T2WI) using 3 tesla (3 T) MRI. Thirty-three patients with elevated prostate specific antigen were evaluated by MRI with T2WI and DWI prior to transperineal template-guided mapping biopsy. The MRI findings were compared with the pathology of biopsy specimens in six parts of prostate : both sides of outer peripheral zones, inner peripheral zones, and transition zones. The sensitivities, specificities and accuracies were 42.1, 84.4 and 76.3％ in T2WI, 57.1, 84.7 and 80.8% in T2WI/DWI, and 87.5, 85.2 and 85.4% in DWI/ADC using 0.951×10 -3 mm2/s as cutoff ADC value. The hazard ratio of patients whose ADC values were under the cutoff was 25.86 by multivariate analysis. Mean ADC values were significantly different between cancer positive and negative cores (p＜0.001). The ADC value showed a negative correlation with increasing tumor length (p＝0.0047). Although further study with a large number of patients is necessary, DWI/ADC using 3 T MRI is a useful tool for detecting prostate cancer.
扩散加权成像（DWI）是一种磁共振成像（MRI）方法，被认为在检测前列腺癌方面可能有用。我们使用3特斯拉（3T）MRI评估了DWI联合表观扩散系数（ADC）图以及T2加权成像（T2WI）的临床价值。33例前列腺特异性抗原升高的患者在经会阴模板引导下穿刺活检前接受了T2WI和DWI的MRI检查。将MRI表现与前列腺六个部位（外周带两侧、内周带和移行带）活检标本的病理结果进行比较。以0.951×10⁻³mm²/s作为ADC截断值时，T2WI的敏感性、特异性和准确性分别为42.1%、84.4%和76.3%；T2WI/DWI分别为57.1%、84.7%和80.8%；DWI/ADC分别为87.5%、85.2%和85.4%。多因素分析显示，ADC值低于截断值的患者风险比为25.86。癌症阳性和阴性核心的平均ADC值有显著差异（p＜0.001）。ADC值与肿瘤长度增加呈负相关（p＝0.0047）。尽管需要对大量患者进行进一步研究，但使用3T MRI的DWI/ADC是检测前列腺癌的有用工具。
