Peker Elif, Sonmez Didem Yasemin, Akkaya Habip Eser, Hayme Serhat, Erden Memet Ilhan, Erden Ayse
Department of Radiology, Ankara University School of Medicine, Ankara, Turkey.
Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey.
Eurasian J Med. 2019 Feb;51(1):31-37. doi: 10.5152/eurasianjmed.2018.18195. Epub 2018 Nov 30.
To investigate the diagnostic performance of multiparametric magnetic resonance imaging (mpMRI) in differentiating prostate cancer (PCa) from prostatitis foci.
This retrospective analysis included 81 biopsy-proven lesions (44 prostatitis and 37 PCa). Normalized T2-signal intensity (nT2SI) and SI on diffusion-weighted imaging (b=1000 and 2000 mm/s), apparent diffusion coefficient (ADC) values, peak SI, SI at the end of the dynamic curves, mean peak time, mean enhancement percentage, and washout percentage obtained from dynamic contrast-enhanced imaging (DCEI) were measured.
nT2SI (3.8 vs. 3.2, p=0.003) and ADC values (0.685×10 mm/s vs. 0.874×10 mm/s, p<0.001) were significantly higher in the prostatitis group than in the PCa group. The washout percentage was the only DCEI parameter that was significantly different between the two groups (12% vs. 4%, respectively, p=0.003). The ADC values alone showed higher sensitivity (80.5%) and specificity (75%) than all of the single criteria and most of the combined criteria. The combination of nT2SI, ADC values, and washout percentage (at least two positive criteria were sufficient for a diagnosis of PCa) yielded the highest sensitivity (77.7%) and specificity (85.7%) among all combinations.
PCa and prostatitis can be discriminated using mpMRI with high sensitivity and specificity.
探讨多参数磁共振成像（mpMRI）在鉴别前列腺癌（PCa）和前列腺炎病灶方面的诊断性能。
这项回顾性分析纳入了81个经活检证实的病变（44个为前列腺炎，37个为PCa）。测量了归一化T2信号强度（nT2SI）、扩散加权成像（b = 1000和2000 mm/s）上的信号强度（SI）、表观扩散系数（ADC）值、峰值SI、动态曲线末期的SI、平均峰值时间、平均增强百分比以及动态对比增强成像（DCEI）获得的洗脱百分比。
前列腺炎组的nT2SI（3.8对3.2，p = 0.003）和ADC值（0.685×10 mm/s对0.874×10 mm/s，p < 0.001）显著高于PCa组。洗脱百分比是两组之间唯一有显著差异的DCEI参数（分别为12%对4%，p = 0.003）。单独的ADC值显示出比所有单一标准和大多数联合标准更高的敏感性（80.5%）和特异性（75%）。nT2SI、ADC值和洗脱百分比的组合（至少两个阳性标准足以诊断PCa）在所有组合中产生了最高的敏感性（77.7%）和特异性（85.7%）。
使用mpMRI可以高敏感性和特异性地鉴别PCa和前列腺炎。
