弥散加权成像eADC值在鉴别诊断前列腺良恶性结节中的应用价值

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Abstract Objective To investigate the feasibility of differential diagnosis of benign and malignant prostate nodules by the exponential apparent dispersion coefficient (eADC) of magnetic resonance imaging (MRI) diffusion weighted imaging (DWI). Methods From November 2016 to July 2019, 50 prostate cancer patients and 50 benign prostatic hyperplasia patients were selected for MRI DWI examination in the Second Affiliated Hospital of Bengbu Medical College, all of which were confirmed by pathology. DWI signal, apparent diffusion coefficient (ADC) value and eADC value of benign and malignant prostate lesions were compared and analyzed. The receiver operating characteristic curve (ROC) was used to obtain the optimal diagnostic cut-off points of ADC and eADC. Results In the 50 patients with benign prostatic hyperplasia, the hyperplasia nodules were located in the central zone and the transitional zone, and the T2 lipid pressure presented heterogeneous mixed signals with unclear boundaries. DWI showed equal or slightly higher signals, ADC image showed slightly higher signals, and eADC image showed low signals. Among the 50 patients with prostate cancer, cancer nodules were located in the peripheral zone in 12 cases, central zone in 7 cases, translobular growth in 5 cases, multiple nodules in 6 cases, diffuse growth in 20 cases, bone metastasis in 2 cases, bone metastasis plus lymph node metastasis in 1 case. The T2 lipid pressure of the cancer nodule presented low or slightly low signal, most of the boundary was clear, DWI showed high or slightly high signal, ADC image showed significantly low signal, and eADC image showed high signal. The mean ADC image value of prostate cancer was lower than that of benign prostatic hyperplasia, and the difference was highly significant (P ＜ 0.01). ADC value was 1.245×10-3 mm2/s as the best diagnostic threshold, with a sensitivity of 94.6% and specificity of 90.0%. The mean value of eADC of prostate cancer was higher than that of benign prostatic hyperplasia, and the difference was highly significant (P ＜ 0.01). The threshold value of eADC was 0.395, with a sensitivity of 95.2% and specificity of 91.5%. The diagnostic efficacy of ADC and eADC was close. Conclusion The eADC image has similar efficacy with ADC image, eliminates the T2 transmission effect and improves tissue contrast, making it a more valuable reference for the evaluation of prostate cancer.

Key words： Prostate cancer Benign prostatic hyperplasia Diffusion weighted imaging Exponential apparent diffusion coefficient Apparent diffusion coefficient

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	LIU Sanchun1 QI Ying1 ZHOU Zhihuai1 YANG Xuezhen2

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LIU Sanchun1 QI Ying1 ZHOU Zhihuai1 YANG Xuezhen2. Application value of diffusion weighted imaging eADC value in differential diagnosis of benign and malignant prostatic nodules[J]. 中国医药导报, 2020, 17(4): 159-162.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I4/159

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