中国CT和MRI杂志
中國CT和MRI雜誌
중국CT화MRI잡지
CHINESE JOURNAL OF CT AND MRI
2015年
1期
64-68
,共5页
前列腺癌%弥散加权成像%磁共振成像
前列腺癌%瀰散加權成像%磁共振成像
전렬선암%미산가권성상%자공진성상
Prostate Cancer%Diffusion-weighted Imaging%Magnatic Resonance Imaging
目的：利用弥散加权成像评估外周叶前列腺癌包膜外扩散敏感性和分级。方法51例患者在前列腺切除术前行3.0T磁共振检查。由2名放射医师应用T2WI评估外周叶包膜外扩散情况，应用ADC图显示及ADC值测量肿瘤和包膜外扩散情况。病理学专家测量包膜外扩散的程度。结果28/102叶发现包膜外扩散，12例测量≦1mm,11例测量>1mm和≦2mm,5例测量>2mm。2名放射医师在T2WI图上检测每叶具体包膜外扩散准确性分别为68.6%、74.5%，ADC图分别显示肿瘤为66.7%、60.8%，ADC值测量分别为75.5%、69.6%。对于包膜外扩散>2mm，2名放射医师利用ADC图或测量ADC值的敏感性为100%，T2WI为80%；对于包膜外扩散≦2mm，除经验不足放射医师应用T2WI检出包膜外扩散敏感性为17.4%，2名放射医师用3种方法检出包膜外扩散敏感性为58.3%-81.8%。2名放射医师应用3种方法检出结果一致性分别为0.18、0.37、0.60。结论 DWI对于评估每个外周叶前列腺癌包膜外扩散术明显准确于T2WI，尤其对于经验不足放射医师评估包膜外扩散2<mm，并且放射医师间评估结果更为一致。
目的：利用瀰散加權成像評估外週葉前列腺癌包膜外擴散敏感性和分級。方法51例患者在前列腺切除術前行3.0T磁共振檢查。由2名放射醫師應用T2WI評估外週葉包膜外擴散情況，應用ADC圖顯示及ADC值測量腫瘤和包膜外擴散情況。病理學專傢測量包膜外擴散的程度。結果28/102葉髮現包膜外擴散，12例測量≦1mm,11例測量>1mm和≦2mm,5例測量>2mm。2名放射醫師在T2WI圖上檢測每葉具體包膜外擴散準確性分彆為68.6%、74.5%，ADC圖分彆顯示腫瘤為66.7%、60.8%，ADC值測量分彆為75.5%、69.6%。對于包膜外擴散>2mm，2名放射醫師利用ADC圖或測量ADC值的敏感性為100%，T2WI為80%；對于包膜外擴散≦2mm，除經驗不足放射醫師應用T2WI檢齣包膜外擴散敏感性為17.4%，2名放射醫師用3種方法檢齣包膜外擴散敏感性為58.3%-81.8%。2名放射醫師應用3種方法檢齣結果一緻性分彆為0.18、0.37、0.60。結論 DWI對于評估每箇外週葉前列腺癌包膜外擴散術明顯準確于T2WI，尤其對于經驗不足放射醫師評估包膜外擴散2<mm，併且放射醫師間評估結果更為一緻。
목적：이용미산가권성상평고외주협전렬선암포막외확산민감성화분급。방법51례환자재전렬선절제술전행3.0T자공진검사。유2명방사의사응용T2WI평고외주협포막외확산정황，응용ADC도현시급ADC치측량종류화포막외확산정황。병이학전가측량포막외확산적정도。결과28/102협발현포막외확산，12례측량≦1mm,11례측량>1mm화≦2mm,5례측량>2mm。2명방사의사재T2WI도상검측매협구체포막외확산준학성분별위68.6%、74.5%，ADC도분별현시종류위66.7%、60.8%，ADC치측량분별위75.5%、69.6%。대우포막외확산>2mm，2명방사의사이용ADC도혹측량ADC치적민감성위100%，T2WI위80%；대우포막외확산≦2mm，제경험불족방사의사응용T2WI검출포막외확산민감성위17.4%，2명방사의사용3충방법검출포막외확산민감성위58.3%-81.8%。2명방사의사응용3충방법검출결과일치성분별위0.18、0.37、0.60。결론 DWI대우평고매개외주협전렬선암포막외확산술명현준학우T2WI，우기대우경험불족방사의사평고포막외확산2<mm，병차방사의사간평고결과경위일치。
Objective To assess the utility of diffusion-weighted imaging(DWI) findings as an indirect marker of side-specific risk of extracapsular extension (ECE) of prostate cancer. Methods Fifty-one patients underwent 3Tmagnetic resonance imaging (MRI) before prostatectomy. Radiologists 1 and 2 assessed each side for ECE using T2-weighted imaging (T2WI) and evaluated apparent diffusion coefficient (ADC) maps for the presence of apparent tumor in each lobe and to measure peripheral zone ADC. A uropathologist measured the extent of any ECE. Results In all, 28/102 lobes had ECE, of which 12 measured≦1 mm, 11 measured>1 mm and≦2 mm, and five measured>2 mm. Side-specific accuracies for detection of ECE for readers 1 and 2 were respectively on T2WI:68.6% and 74.5%; presence of apparent tumor on ADC map 66.7% and 60.8%; ADC value 75.5% and 69.6%. For ECE>2 mm, both readers achieved 100% sensitivity based on apparent tumor on ADC map or ADC values and 80% sensitivity using T2WI. For detection of ECE≦2 mm, sensitivity for all combinations of the three methods and two readers ranged from 58.3%–81.8%, aside from assessment for ECE using T2WI by the less experienced reader, which exhibited sensitivity of 17.4%. Interreader agreement for the presence of ECE was 0.18 using T2WI, 0.37 using apparent tumor on ADC map, and 0.60 using ADC values. Conclusion Compared with T2WI, DWI had comparable accuracy for side-specific assessment of ECE, greater sensitivity for ECE <2 mm for the less-experienced radiologist,and greater interreader agreement.
