CAJ | 학술논문

目的：比较MRI肝脏快速容积采集序列（ LAVA）增强扫描和抑脂扰相梯度回波序列（ FS-SPGR）增强扫描对前列腺癌的诊断价值。方法选择2010年6月—2013年10月因血精、血尿、夜尿增多等泌尿系统临床表现在嘉兴市第二医院就诊或实验室检查血清前列腺特异性抗原异常者92例，按随机数字表法决定患者增强扫描序列。采用LAVA增强扫描患者44例，采用FS-SPGR增强扫描患者48例，检查后3个月内进行首次穿刺或手术获得病理资料确诊。应用诊断性试验计算两种增强扫描方式的诊断总符合率、灵敏度、特异度、阳性预测值、阴性预测值、约登指数（ Youden指数）、阳性似然比、阴性似然比，采用χ2检验比较差异有无统计学意义。结果16例患者经LAVA增强扫描诊断为前列腺癌，在增强图像上表现为“快进快出”，结节状占位灶在动态增强早期明显强化；16例患者经FS-SPGR增强扫描诊断为前列腺癌，在增强图像上显示占位灶呈不均匀强化。两种方式增强扫描诊断前列腺癌的总符合率、灵敏度、特异度、阳性预测值和阴性预测值比较，差异均无统计学意义（ P >0.05）。结论采用 LAVA 和FS-SPGR两种方式增强扫描诊断前列腺癌准确性相似，但采用LAVA多期动态增强扫描时间较短，两种方式增强扫描对前列腺癌均有较大诊断价值。
목적：비교MRI간장쾌속용적채집서렬（ LAVA）증강소묘화억지우상제도회파서렬（ FS-SPGR）증강소묘대전렬선암적진단개치。방법선택2010년6월—2013년10월인혈정、혈뇨、야뇨증다등비뇨계통림상표현재가흥시제이의원취진혹실험실검사혈청전렬선특이성항원이상자92례，안수궤수자표법결정환자증강소묘서렬。채용LAVA증강소묘환자44례，채용FS-SPGR증강소묘환자48례，검사후3개월내진행수차천자혹수술획득병리자료학진。응용진단성시험계산량충증강소묘방식적진단총부합솔、령민도、특이도、양성예측치、음성예측치、약등지수（ Youden지수）、양성사연비、음성사연비，채용χ2검험비교차이유무통계학의의。결과16례환자경LAVA증강소묘진단위전렬선암，재증강도상상표현위“쾌진쾌출”，결절상점위조재동태증강조기명현강화；16례환자경FS-SPGR증강소묘진단위전렬선암，재증강도상상현시점위조정불균균강화。량충방식증강소묘진단전렬선암적총부합솔、령민도、특이도、양성예측치화음성예측치비교，차이균무통계학의의（ P >0.05）。결론채용 LAVA 화FS-SPGR량충방식증강소묘진단전렬선암준학성상사，단채용LAVA다기동태증강소묘시간교단，량충방식증강소묘대전렬선암균유교대진단개치。
Objective To analyze the diagnostic value of contrast enhancement by 1iver acquisition with volume accel-eration( LAVA)and fat-suppressed spoiled gradient echo( FS-SPGR)in prostate cancer detection. Methods A total of 92 patients with abnormal PSA given laboratory examination and urinary system symptoms like hematospermia,hematuresis and in-creased nocturia admitted to the Second Hospital of Jiaxing from June 2010 to October 2013 were randomly divided into LAVA group(44 cases)and FS-SPGR group(48 cases). During the first three months after MRI examination,histopathological re-sults were obtained through biopsy and transurethral resection of the prostate. By applying diagnostic test,the coincidence rate, sensitivity,specificity,positive predictive value,negative predictive value,Youden index,positive likelihood ratio and nega-tive likelihood ratio in the contrast enhancement scanning by LAVA and FS-SPGR were detected,and chi square test was used to analyze the statistical significance of the difference. Results 16 patients by LAVA enhanced scanning were diagnosed with prostate cancer,with enhancing image characterized by " fast forward" and the nodular focal placeholder significantly enhanced in the early dynamic stage. 16 patients with FS -SPGR enhancement scanning were diagnosed with prostate cancer,with en-hanced image characterized by uneven placeholder. The two methods in the diagnosis of prostate cancer showed no statistically sig-nificant difference in coincidence rate,sensitivity,specificity,positive predictive value and negative predictive value( P >0. 05). Conclusion The LAVA and FS-SPGR have similar accuracy in the diagnosis of prostate cancer,but the LAVA multi-phase dynamic enhanced scanning has shorter time. Both methods of the enhancement scanning is of great diagnostic value for pros-tate cancer.