CAJ | 학술논문

目的评价磁共振弥散加权成像(DWI)在前列腺癌诊断及鉴别诊断中的应用价值。方法 53例前列腺特异性抗原(PSA)异常、直肠指检或超声异常的疑似前列腺癌患者，术前行DWI检查，对比术后病理结果，分析其表观弥散系数(ADC)值。结果术后病理检查发现前列腺癌15例，前列腺增生37例，上皮内瘤变1例。在弥散敏感系数(b)值1 000s/mm2下前列腺癌组癌区与前列腺增生组外周带ADC值分别为(0.813 ±0. 25)×10-3 mm/s与(1.45±0.24)×10-3mm/s,两者差异有统计学意义（t=-26.117,P＜0.01）。在b值600 s/mm2下前列腺癌组癌区与前列腺增生组外周带ADC值分别为(1. 03±0. 27)×10-3 mm/s与(1.62±0.33)×10-3 mm/s,两者差异有统计学意义（t=-24.191,P＜0.01）。DWI的接受者操作特性(ROC)曲线下面积为0.862，敏感性与特异性分别为78.1％及91.5％。结论 DWI可为前列腺癌的鉴别诊断提供量化信息，具有较好的临床应用价值。
목적 평개자공진미산가권성상(DWI)재전렬선암진단급감별진단중적응용개치。방법 53례전렬선특이성항원(PSA)이상、직장지검혹초성이상적의사전렬선암환자，술전행DWI검사，대비술후병리결과，분석기표관미산계수(ADC)치。결과 술후병리검사발현전렬선암15례，전렬선증생37례，상피내류변1례。재미산민감계수(b)치1 000s/mm2하전렬선암조암구여전렬선증생조외주대ADC치분별위(0.813 ±0. 25)×10-3 mm/s여(1.45±0.24)×10-3mm/s,량자차이유통계학의의（t=-26.117,P＜0.01）。재b치600 s/mm2하전렬선암조암구여전렬선증생조외주대ADC치분별위(1. 03±0. 27)×10-3 mm/s여(1.62±0.33)×10-3 mm/s,량자차이유통계학의의（t=-24.191,P＜0.01）。DWI적접수자조작특성(ROC)곡선하면적위0.862，민감성여특이성분별위78.1％급91.5％。결론 DWI가위전렬선암적감별진단제공양화신식，구유교호적림상응용개치。
Objective To evaluate the application value of magnetic resonance diffusion weighted imaging (DWI)in diagnosis and differential diagnosis of prostate cancer. Methods 53 Cases of suspected prostate cancer patients with elevated prostate-specific antigen, abnormal digital rectal examination or ultrasound examination were underwent DWI examination before operation. Apparent dispersion coefficient was measured and compared to pathological results. Results There were 15 cases of prostate cancer, 37 cases of benign prostate hyperplasia and one prostatic intraepithelial neoplasia. When b =1 000 s/mm2 ,the ADC values of foci area in prostate cancer group and peripheral zone in benign prostate hyperplasia group were (0.813 ±0.25) × 10-3mm/8 and (1.45±0.24) × 10-3mm/s respectively, and the difference had statistical significance(t =-26. 117,P ＜0. 01 ). When b =60D s/mm2, the ADC values of foci area in prostate cancer group and peripheral zone in benign prostate hyperplasia group were ( 1.03 ± 0. 27) × 10-3 mm/s and ( 1.62 ± 0. 33) × 10- 3 mm/s respectively, and the difference had statistical significance( t =- 24. 191, P ＜ 0. 01 ). The area under the ROC curves was 0.862, and the sensitivity and specificity of DWI were 78.1％ and 91.5％ respectively.Conclusion DWI can provide quantitative information for prostate cancer diagnosis and differential diagnosis,therefore it possesses a good clinical application value.