高 b 值（2000 s/mm2）在 3T 磁共振成像中的前列腺癌：与 1000 s/mm2 比较用于肿瘤显示和侵袭性的鉴别。
High b value (2,000 s/mm2) diffusion-weighted magnetic resonance imaging in prostate cancer at 3 Tesla: comparison with 1,000 s/mm2 for tumor conspicuity and discrimination of aggressiveness.
机构信息
Department of Radiology, Kawasaki Medical School, Kurashiki city, Okayama, Japan.
Department of Pathology, Kawasaki Medical School, Kurashiki city, Okayama, Japan.
出版信息
PLoS One. 2014 May 6;9(5):e96619. doi: 10.1371/journal.pone.0096619. eCollection 2014.
OBJECTIVE
The objective of our study was to investigate tumor conspicuity and the discrimination potential for tumor aggressiveness on diffusion-weighted magnetic resonance imaging (DW-MRI) with high b value at 3-T.
MATERIALS AND METHODS
The institutional review board approved this study and waived the requirement for informed consent. A total of 50 patients with prostate cancer (69 cancer foci; 48 in the PZ, 20 in the TZ, and one in whole prostate) who underwent multiparametric prostate MRI including DW-MRI (b values: 0, 1000 s/mm2 and 0, 2000 s/mm2) on a 3-T system were included. Lesion conspicuity score (LCS) using visual assessment (1 = invisible for surrounding normal site; 2 = slightly high intensity; 3 = moderately high; and 4 = very high) and tumor-normal signal intensity ratio (TNR) were assessed, and apparent diffusion coefficient (ADC, ×10-3 mm2/s) of the tumor regions and normal regions were measured.
RESULTS
Mean LCS and TNR at 0, 2000 s/mm2 was significantly higher than those at 0, 1000 s/mm2 (p<0.001 for both). In addition, ADC at both 0, 1000 and 0, 2000 s/mm2 was found to distinguish intermediate or high risk cancer with Gleason score ≥7 from low risk cancer with Gleason score ≤6 (p<0.001 for both). Furthermore, ADC of tumor regions correlated with Gleason score at both 0, 1000 s/mm2 (ρ = -0.602; p<0.001) and 0, 2000 s/mm2 (ρ = -0.645; p<0.001).
CONCLUSIONS
For tumor conspicuity and characterization of prostate cancer on DW-MRI of 3-T MRI, b = 0, 2000 s/mm2 is more useful than b = 0, 1000 s/mm2.
目的
本研究旨在探讨高 b 值（3-T 时为 0、1000 s/mm2 和 0、2000 s/mm2）扩散加权磁共振成像（DW-MRI）上肿瘤的显影程度和对肿瘤侵袭性的鉴别潜力。
材料与方法
本研究经机构审查委员会批准，并豁免了知情同意书的要求。共纳入 50 例前列腺癌患者（69 个病灶；48 个位于移行区，20 个位于外周区，1 个位于整个前列腺），这些患者均在 3-T 系统上接受了包括 DW-MRI 在内的多参数前列腺 MRI 检查。使用视觉评估（1=周围正常部位不可见；2=稍高信号强度；3=中度高；4=非常高）评估病灶显影评分（LCS）和肿瘤-正常信号强度比（TNR），并测量肿瘤区域和正常区域的表观扩散系数（ADC，×10-3 mm2/s）。
结果
0、2000 s/mm2 时的平均 LCS 和 TNR 显著高于 0、1000 s/mm2 时（均 p<0.001）。此外，0、1000 和 0、2000 s/mm2 时的 ADC 也可区分 Gleason 评分≥7 的中高危癌症与 Gleason 评分≤6 的低危癌症（均 p<0.001）。此外，0、1000 s/mm2 时肿瘤区域的 ADC 与 Gleason 评分呈负相关（ρ=-0.602；p<0.001），0、2000 s/mm2 时肿瘤区域的 ADC 与 Gleason 评分呈负相关（ρ=-0.645；p<0.001）。
结论
对于 3-T MRI 的 DW-MRI 上肿瘤的显影程度和前列腺癌的特征，b=0、2000 s/mm2 比 b=0、1000 s/mm2 更有用。
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