Anwar Shayan Sirat Maheen, Anwar Khan Zahid, Shoaib Hamid Rana, Haroon Fahd, Sayani Raza, Beg Madiha, Khattak Yasir Jamil
Department of Radiology, The Aga Khan University Hospital, P.O. Box 3500, Stadium Road, Karachi 74800, Pakistan.
Department of Medical Imaging, King Abdul Aziz Hospital, National Guards Health Affairs, P.O. Box 2477, Al-Ahsa 31982, Saudi Arabia.
ISRN Radiol. 2014 Feb 9;2014:263417. doi: 10.1155/2014/263417. eCollection 2014.
Purpose. To determine association between apparent diffusion coefficient value on diffusion-weighted imaging and Gleason score in patients with prostate cancer. Methods. This retrospective case series was conducted at Radiology Department of Aga Khan University between June 2009 and June 2011. 28 patients with biopsy-proven prostate cancer were included who underwent ultrasound guided sextant prostate biopsy and MRI. MRI images were analyzed on diagnostic console and regions of interest were drawn. Data were entered and analyzed on SPSS 20.0. ADC values were compared with Gleason score using one-way ANOVA test. Results. In 28 patients, 168 quadrants were biopsied and 106 quadrants were positive for malignancy. 89 lesions with proven malignancy showed diffusion restriction. The mean ADC value for disease with a Gleason score of 6 was 935 mm(2)/s (SD = 248.4 mm(2)/s); Gleason score of 7 was 837 mm(2)/s (SD = 208.5 mm(2)/s); Gleason score of 8 was 614 mm(2)/s (SD = 108 mm(2)/s); and Gleason score of 9 was 571 mm(2)/s (SD = 82 mm(2)/s). Inverse relationship was observed between Gleason score and mean ADC values. Conclusion. DWI and specifically quantitative ADC values may help differentiate between low-risk (Gleason score, 6), intermediate-risk (Gleason score, 7), and high-risk (Gleason score 8 and 9) prostate cancers, indirectly determining the aggressiveness of the disease.
目的。确定前列腺癌患者扩散加权成像上的表观扩散系数值与 Gleason 评分之间的关联。方法。本回顾性病例系列研究于 2009 年 6 月至 2011 年 6 月在阿迦汗大学放射科进行。纳入 28 例经活检证实为前列腺癌的患者，这些患者接受了超声引导下的前列腺六分区活检和 MRI 检查。在诊断控制台分析 MRI 图像并绘制感兴趣区域。数据录入 SPSS 20.0 进行分析。使用单因素方差分析检验比较 ADC 值与 Gleason 评分。结果。28 例患者中，共活检 168 个象限，其中 106 个象限为恶性阳性。89 个经证实为恶性的病灶显示出扩散受限。Gleason 评分为 6 的疾病的平均 ADC 值为 935 mm²/s（标准差 = 248.4 mm²/s）；Gleason 评分为 7 的为 837 mm²/s（标准差 = 208.5 mm²/s）；Gleason 评分为 8 的为 614 mm²/s（标准差 = 108 mm²/s）；Gleason 评分为 9 的为 571 mm²/s（标准差 = 82 mm²/s）。观察到 Gleason 评分与平均 ADC 值之间呈负相关。结论。DWI 尤其是定量 ADC 值可能有助于区分低风险（Gleason 评分，6）、中风险（Gleason 评分，7）和高风险（Gleason 评分 8 和 9）前列腺癌，间接确定疾病的侵袭性。
