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[磁共振扩散加权成像及表观扩散系数在前列腺癌检测及病理Gleason评分预测中的应用]

[Utility of diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient in detection of prostate cancer and prediction of pathologic Gleason score].

作者信息

Kagebayashi Yoriaki, Nakai Yasushi, Matsumoto Yoshihiro, Samma Shoji, Miyasaka Toshiteru, Nakagawa Hiroyuki

机构信息

The Department of Urology, Nara Prefectural Nara Hospital.

出版信息

Hinyokika Kiyo. 2012 Aug;58(8):405-8.

Abstract

Thirty patients with histologically proven prostate cancer whose prostate specific antigen values were under 20 ng/ml received magnetic resonance imaging (MRI) at 1.5 T before transrectal ultrasound-guided systematic transrectal 10-core needle biopsy. Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) on MRI were retrospectively analyzed by a single radiologist without any information of the results of the biopsy. The locations of cancer, indicated by the results of biopsy, coincided with the findings of MRI in 25 patients (83.3%). The characteristics of DWI and ADC in the lesion with a cancer focus could be analyzed in 21 patients. The mean ADC of cancer lesions was 0.96 ± 0.36 × 10⁻³ mm²/sec (± SD). The mean ADC of cancer lesions with a Gleason score of 6 was 1.14 ± 0.40 × 10⁻³ mm²/sec, while that of lesions with Gleason scores of 7 and 8 was 0.77 ± 0.20 × 10⁻³ mm²/s (p = 0.008, unpaired t test). DWI and ADC would be useful parameters in the diagnosis of prostate cancer. ADC of a cancer lesion may indicate the malignant potential of cancer cells represented by the Gleason score.

摘要

30例经组织学证实为前列腺癌且前列腺特异性抗原值低于20 ng/ml的患者,在经直肠超声引导下进行系统经直肠10针穿刺活检前接受了1.5 T的磁共振成像(MRI)检查。由一名放射科医生对MRI上的扩散加权成像(DWI)和表观扩散系数(ADC)进行回顾性分析,该医生对活检结果一无所知。活检结果所显示的癌灶位置与MRI检查结果在25例患者(83.3%)中相符。在21例患者中能够分析出具有癌灶的病变中DWI和ADC的特征。癌灶的平均ADC为0.96±0.36×10⁻³ mm²/秒(±标准差)。Gleason评分为6分的癌灶平均ADC为1.14±0.40×10⁻³ mm²/秒,而Gleason评分为7分和8分的病变平均ADC为0.77±0.20×10⁻³ mm²/秒(p = 0.008,非配对t检验)。DWI和ADC在前列腺癌的诊断中可能是有用的参数。癌灶的ADC可能表明由Gleason评分所代表的癌细胞的恶性潜能。

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