Value of MR dynamic enhancement combined with conventional T2WI and diffusion weighted imaging in the diagnosis of prostate cancer / 中国医师杂志

ABSTRACT

Objective:To explore the value of combined application of T2WI, diffusion weighted imaging (DWI) and magnetic resonance dynamic enhanced scanning (DCE-MRI) in the diagnosis of prostate cancer (PCa).Methods:A total of 50 PCa patients received in the First People's Hospital of Pinghu from March 2015 to August 2018 were selected as the PCa group, 54 patients with benign prostatic hyperplasia (BPH) in the same period were selected as the BPH group for a cross-sectional study. Both groups of patients underwent conventional MR scans. The apparent diffusion coefficient (ADC), exponential apparent diffusion coefficient (EADC), peak time (Tmax), peak intensity (SIpeak), signal enhancement rate (SER), maximum enhancement slope (MSI) and time signal intensity (TIC) curve types were compared between the two groups, and the differences between the cancerous and non cancerous foci were analyzed comprehensively. The results of T2WI, DWI and DCE-MRI were statistically analyzed, and the diagnostic efficacy of the three methods alone and combined in the diagnosis of PCA were compared.Results:The ADC value of PCa group was lower than that of BPH group, and the EADC value was higher than that of BPH group ( P<0.05); the Tmax value of the PCa group was lower than that of the BPH group, and the SER and MSI values were higher than those of the BPH group ( P<0.05); the proportion of type Ⅲ TIC curves in the PCa group (64.00%) was higher than that in the BPH group (14.81%), and the proportion of type Ⅱ TIC curves (24.00%) was lower than in the BPH group (66.67%, P<0.05); Conventional T2WI sequence diagnosed 32 cases of cancer, and 10 cases of BPH patients detected low signal in peripheral zone; DWI detected 34 cases of cancer, and 10 cases of BPH patients detected slightly high signal nodules in central gland area, ADC signal was slightly low, and 6 cases of hyperplastic peripheral zone high signal patchy shadow; DCE-MRI showed early obvious enhancement in 42 cases of 50 cases of PCA patients, and decreased rapidly or slowly, and 2 cases showed low peak in 54 cases of BPH, 10 cases of T2WI detected low signal area; 16 cases of DWI detected slightly high signal nodules, of which 8 cases of ADC showed slightly low signal; 46 cases showed early obvious enhancement and gradually increased, or showed platform enhancement; 8 cases of central proliferative nodules showed early obvious enhancement and early enhancement. The sensitivity (96.00%) and accuracy (92.31%) of T2WI, DWI and DCE-MRI in the diagnosis of PCA were higher than those of the three methods alone ( P<0.05). Conclusions:T2WI, DWI, DCE-MRI combined examination can obtain more comprehensive lesion information, significantly improve the sensitivity and accuracy of PCa diagnosis, and help to reduce missed diagnosis.