CAJ | 학술논문

目的探讨前列腺三维扩散张量成像（DTI）融合轴面T2WI图像对提高医师评估前列腺周围神经血管束（NVB）能力的价值。方法回顾性分析临床怀疑为前列腺肿瘤行前列腺常规MRI T2WI和三维DTI检查的69例患者。对DTI数据进行后处理，获得三维DTI融合轴面T2WI图像。由4名医师同时独立对69例患者138侧NVB在轴面T2WI和三维DTI融合轴面T2WI上的显示进行评分。4名医师分别为有1年前列腺MRI诊断经验的低年资放射科医师（医师1）、有5年前列腺MRI诊断经验的低年资放射科医师（医师2）、有3年前列腺外科手术经验的泌尿外科医师（医师3）和有13年前列腺MRI诊断经验的高年资放射科医师（医师4）。对每名医师T2WI与三维DTI融合轴面T2WI的评分采用非参数Wilcoxon秩和检验进行比较。结果上述4名医师在T2WI上NVB的评分分别为（2.9±0.8）、（3.0±1.1）、（1.6±0.7）和（3.8±0.5）分，在三维DTI融合轴面T2WI上NVB的评分分别为（4.4±0.6）、（4.3±0.8）、（4.2±0.6）和（4.9±0.3）分，4名医师的三维DTI融合轴面T2WI评分均高于T2WI评分，差异有统计学意义（Z值分别为－12.791、－9.737、－14.538和－14.901，P均<0.01）。泌尿外科医师评分提升最大，高年资放射科医师提升最小。结论三维DTI融合轴面T2WI能提高不同资历放射科及外科医师评估前列腺NVB的能力。
목적탐토전렬선삼유확산장량성상（DTI）융합축면T2WI도상대제고의사평고전렬선주위신경혈관속（NVB）능력적개치。방법회고성분석림상부의위전렬선종류행전렬선상규MRI T2WI화삼유DTI검사적69례환자。대DTI수거진행후처리，획득삼유DTI융합축면T2WI도상。유4명의사동시독립대69례환자138측NVB재축면T2WI화삼유DTI융합축면T2WI상적현시진행평분。4명의사분별위유1년전렬선MRI진단경험적저년자방사과의사（의사1）、유5년전렬선MRI진단경험적저년자방사과의사（의사2）、유3년전렬선외과수술경험적비뇨외과의사（의사3）화유13년전렬선MRI진단경험적고년자방사과의사（의사4）。대매명의사T2WI여삼유DTI융합축면T2WI적평분채용비삼수Wilcoxon질화검험진행비교。결과상술4명의사재T2WI상NVB적평분분별위（2.9±0.8）、（3.0±1.1）、（1.6±0.7）화（3.8±0.5）분，재삼유DTI융합축면T2WI상NVB적평분분별위（4.4±0.6）、（4.3±0.8）、（4.2±0.6）화（4.9±0.3）분，4명의사적삼유DTI융합축면T2WI평분균고우T2WI평분，차이유통계학의의（Z치분별위－12.791、－9.737、－14.538화－14.901，P균<0.01）。비뇨외과의사평분제승최대，고년자방사과의사제승최소。결론삼유DTI융합축면T2WI능제고불동자력방사과급외과의사평고전렬선NVB적능력。
Objective To determine whether hybrid three dimensional diffusion tensor imaging (3D DTI) contributes incremental value to standard T2WI technique for assessing neurovascular bundles (NVB) around the prostate. Methods This retrospective institutional review board-approved study included 69 consecutive patients with prostate tumor who underwent MRI including conventional T2WI and 3D DTI . DTI data were postprocessed and hybrid 3D DTI and axial T2W images were obtained. Three radiologists with one, five and thirteen years of experience in reading prostate MRI and one urologist with three years of surgical experience in urology who were blinded to patient data independently recorded their levels of preference on a five-point scale of the NVBs around the prostate on the basis of T2WI alone and hybrid 3D DTI and T2WI, respectively. The differences of scores of T2WI and hybrid 3D DTI and T2WI of the four doctors were compared by using nonparametric Wilcoxon rank. Results The average scores of hybrid 3D DTI to T2WI and alone T2WI to assess NVBs for 3 radiologists and one urologist were 4.4±0.6, 4.3±0.8, 4.2± 0.6, 4.9±0.3 and 2.9±0.8, 3.0±1.1, 1.6±0.7, 3.8±0.5, respectively. The hybird 3D DTI to T2WI improved the discrimination abilities of NVBs around the prostate for 3 radiologists and one urologist (Z values were-12.791,-9.737,-14.538,-14.901, P<0.01 respectively).The added value of hybrid DTI to T2WI for urologist is the highest, and experienced radiologist is the smallest. Conclusion The hybrid 3D DTI <br> contributes significant incremental value to the standard T2WI technique for assessing NVB around the prostate.