CAJ | 학술논문

目的：比较分段读出平面回波成像(readout-segmented echo-planar imaging, RS-EPI)与单次激发平面回波成像(single-shot echo-planar imaging, SS-EPI)在早期前列腺癌诊断中的价值。材料与方法回顾性纳入20例行3.0T MRI SS-EPI和RS-EPI检查的早期前列腺癌患者。两位影像科医生在不提供任何临床资料的情况下参照PI-RADS标准分析T2WI、RS-EPI和SS-EPI图像，按六分区法对前列腺各个分区出现癌的可能性进行评分。共组成5种方案：方案1：T2WI；方案2：SS-EPI；方案3：RS-EPI；方案4：T2WI+SS-EPI；方案5：T2WI+RS-EPI。采用受试者工作特征(receiver operating characteristic, ROC)曲线比较5种方案的诊断效能。结果方案1～5的曲线下面积分别为0.789、0.790、0.874、0.838、0.881，由高到低的顺序为T2WI+RS-EPI＞RS-EPI＞T2WI+SS-EPI＞SS-EPI＞T2WI。方案1与方案3、方案4、方案5，方案2与方案3、方案4，方案4与方案5之间ROC曲线下面积差异有统计学意义(P＜0.05)。方案1与方案2，方案3与方案4、方案5之间ROC曲线下面积差异无统计学意义(P＞0.05)。结论 T2WI联合应用DWI可提高早期前列腺癌的诊断效能，T2WI联合RS-EPI的诊断效能高于T2WI联合SS-EPI，更利于临床早期前列腺癌的诊断。
목적：비교분단독출평면회파성상(readout-segmented echo-planar imaging, RS-EPI)여단차격발평면회파성상(single-shot echo-planar imaging, SS-EPI)재조기전렬선암진단중적개치。재료여방법회고성납입20례행3.0T MRI SS-EPI화RS-EPI검사적조기전렬선암환자。량위영상과의생재불제공임하림상자료적정황하삼조PI-RADS표준분석T2WI、RS-EPI화SS-EPI도상，안륙분구법대전렬선각개분구출현암적가능성진행평분。공조성5충방안：방안1：T2WI；방안2：SS-EPI；방안3：RS-EPI；방안4：T2WI+SS-EPI；방안5：T2WI+RS-EPI。채용수시자공작특정(receiver operating characteristic, ROC)곡선비교5충방안적진단효능。결과방안1～5적곡선하면적분별위0.789、0.790、0.874、0.838、0.881，유고도저적순서위T2WI+RS-EPI＞RS-EPI＞T2WI+SS-EPI＞SS-EPI＞T2WI。방안1여방안3、방안4、방안5，방안2여방안3、방안4，방안4여방안5지간ROC곡선하면적차이유통계학의의(P＜0.05)。방안1여방안2，방안3여방안4、방안5지간ROC곡선하면적차이무통계학의의(P＞0.05)。결론 T2WI연합응용DWI가제고조기전렬선암적진단효능，T2WI연합RS-EPI적진단효능고우T2WI연합SS-EPI，경리우림상조기전렬선암적진단。
Objectives:To compare the clinical utility of readout-segmented echo-planar imaging (RS-EPI) with single-shot echo-planar imaging (SS-EPI) in diagnosing early prostatic cancers. Materials and Methods: Twenty surgically-proved early prostate cancer patients were collected in this retrospective study. T2WI, RS-EPI and SS-EPI were evaluated by two blinded radiologists. By using 6 sub-region classiifcation method the possibility of the presence of cancer at each sub-region was scored according to the PI-RADS system. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efifcacy of the following 6 protocols: T2WI alone (protocol 1), SS-EPI alone (protocol 2), RS-EPI (protocol 3), a combination of T2WI and SS-EPI (protocol 4) and a combination of T2WI and RS-EPI (protocol 5). Results:The area under the ROC curve (Az) of protocol 1 to protocol 5 for region-based analysis were 0.789, 0.790, 0.874, 0.838, 0.881, respectively. ROC analysis revealed signiifcant differences between protocol 1 and 3, 4, 5, and between protocol 2 and 3, 4, and between protocol 4 and 5 (P<0.05). While the difference between protocol 1 and 2, between 3 and 4, 5 has no statistical significance (P>0.05). Conclusions:The combination of T2WI and DWI can improve the diagnosis ability of early prostate cancers. Combination of T2WI and RS-EPI is a more effective approach than combination of T2WI and SS-EPI for the detection of early prostate cancers.