Abstract:Objective: To explore the feasibility of the enhanced T2 star weighted angiography(ESWAN) MRI post-processed multiple parameters in differential diagnosis of prostate cancer(PCa) and benign prostatic hyperplasia(BPH). Methods: In this retrospective study, 56 patients with pathologically confirmed prostate lesions(26 cases of PCa group, 30 cases of BPH group) were reviewed. All the patients underwent prostate MRI exams on a GE SignaHDxt 3.0T MRI scanner. The R2*, phase, and ADC values of each lesion region were obtained with the region of interest manually circled. The measurements of the same patient were done independently by two observers, and the mean values of the 3 measurements were used for statistical analysis. Using SPSS 17.0 statistical software for data analysis. The differences of age between the two groups was analyzed by Mann-Whitney test. The results(R2* values, phase values and ADC values) of the two observers were using Spearman test. R2* value, phase value, ADC value between PCa and BPH groups and those between poorly differentiated group and the well differentiated group were compared with the Mann-Whitney test. The receiver operating characteristic curves(ROC) were used to determine the performances of the R2*, phase and ADC values, and to calculate cutoff value. Result: ①There is no significant difference in age between PCa group and BPH group.②Two observers’ measurement results of R2*, phase and ADC values were in good agreement. ③The values of R2*, phase and ADC between PCa and BPH show significant difference. The AUC of R2* values were 0.914 and the corresponding cutoff value were 21.06 Hz, the sensitivity and specificity were 92.3% and 83.3%. The AUC of phase values were 0.664 and the corresponding cutoff value were 0.010 7 Hz, the sensitivity and specificity were 69.2% and 73.3%. The AUC of ADC values were 0.903 and the corresponding cutoff value were 0.958×10-3 mm2/s, the sensitivity and specificity were 88.5% and 90.0%. ④No significant difference in the values of R2*, phase, ADC was found between poorly differentiated group and the well differentiated group. Conclusion: The values of R2*, phase measured in ESWAN were valuable information in different diagnosis of PCa and BPH. The value of R2* had higher AUC than ADC, and higher sensitivity than ADC. ESWAN sequence has good prospect in the different diagnosis of PCa and BPH.
佟梓滨,刘爱连,陈丽华,吕婷婷,李 烨,陈安良,宋清伟. ESWAN序列对前列腺癌与前列腺增生鉴别诊断的价值[J]. 中国临床医学影像杂志, 2016, 27(6): 411-415.
TONG Zi-bin, LIU Ai-lian, CHEN Li-hua, LV Ting-ting, LI Ye, CHEN An-liang, SONG Qing-wei. ESWAN technique in the differential diagnosis of prostate cancer and prostate hyperplasia. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(6): 411-415.
[1]韩苏军,张思维,陈万青,等. 中国前列腺癌发病现状和流行趋势分析[J]. 临床肿瘤学杂志,2013,18(4):330-334.
[2]Gao T, Wang Y, Zhang Z. Silent cerebral microbleeds on susceptibility-weighted imaging of patients with ischemic stroke and leukoaraiosis[J]. Neurol Res, 2008, 30(3): 272-276.
[3]Santhosh K, Kesavadas C, Thomas B, et al. Susceptibility weighted imaging: a new tool in magnetic resonance imaging of stroke[J]. Clin Radiol, 2009, 64(1): 74-83.
[4]王升. ESWAN序列在肝细胞癌与肝血管瘤鉴别中的应用价值初探[D]. 大连:大连医科大学,2013.
[5]田士峰,刘爱连,李烨,等. 多模态磁共振成像对脾脏实性良恶性肿瘤鉴别诊断的价值[J]. 中国临床医学影像杂志,2014,25(11):781-786.
[6]李莉莉,王光彬,王锡臻,等. ESWAN在判断前列腺癌和良性前列腺增生微量出血的价值研究[J]. 临床放射学杂志,2014,33(4):532-535.
[7]Suo S, Chen X, Zhang X, et al. Non-Gaussian water diffusion krutosis imaging of prostate cancer[J]. Magn Reson Imaging, 2014, 32(5): 421-427.
[8]Chopra S, Foltz WD, Milosevic MF, et al. Comparing oxygen-sensitive MRI(BOLD R2*) with oxygen electrode measurements: A pilot study in men with prostate cancer[J]. Int J Radiat Biol, 2009, 85(9): 805-813.