高分辨率MRI联合DWI对前列腺病变良恶性鉴别诊断的价值

Diagnostic value of high-resolution MRI combined with DWI in the differentiation of benign and malignant prostate lesions

摘要

目的：探讨高分辨率磁共振成像（HR-MRI）联合弥散加权成像（DWI）在前列腺病变良恶性鉴别诊断中的价值。方法：对郴州市第一人民医院收治的108例前列腺病变患者的临床资料进行回顾性分析，根据病理结果分为良性组（n=57）和恶性组（n=51），分析HR-MRI+DWI诊断前列腺病变良恶性的价值。结果：两组患者前列腺体积比较无显著差异（P>0.05），恶性组表观扩散系数低于良性组（P<0.05）；以病理结果为金标准，HR-MRI、DWI单独及联合检查鉴别前列腺病变的Kappa值分别为0.572、0.684、0.833（P<0.05）。HR-MRI联合DWI在前列腺病变鉴别诊断中的灵敏度、准确率为94.12%、91.67%，均高于HR-MRI（76.47%、78.90%）和DWI（82.35%、84.26%）单独检查（P<0.05）。结论：HR-MRI联合DWI在前列腺病变良恶性鉴别诊断中具有较高的应用价值。

Abstract

Objective To explore the value of high-resolution magnetic resonance imaging (HR-MRI) combined with diffusion-weighted imaging (DWI) in the differential diagnosis of benign and malignant prostate lesions. Methods A retrospective analysis was performed on the clinical data of 108 patients with prostate lesions admitted to the Chenzhou No.1 People's Hospital. Patients were categorized into benign (n=57) and malignant (n=51) groups according to pathological results, and the diagnostic efficacy of HR-MRI combined with DWI was assessed for differentiating benign and malignant prostate lesions. Results No significant differences were observed in prostate volume between the two groups (P>0.05), but apparent diffusion coefficient in malignant group was lower than that in benign group (P<0.05). With pathological findings as the gold standard, the consistency Kappa values of HR-MRI, DWI, and their combination for distinguishing benign and malignant prostate lesions were 0.572, 0.684, and 0.833, respectively (P<0.05). The sensitivity and accuracy of HR-MRI combined with DWI in differentiating prostate lesions were 94.12% and 91.67%, higher than those of HR-MRI alone (76.47%, 78.90%) and DWI alone (82.35%, 84.26%) (P<0.05). Conclusion HR-MRI combined with DWI exhibit higher application value in the differential diagnosis of benign and malignant prostate lesions.

关键词

前列腺病变 / 鉴别诊断 / 磁共振成像 / 高分辨率 / 弥散加权成像

Key words

prostate lesion / differential diagnosis / magnetic resonance imaging / high resolution / diffusion-weighted imaging

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基金资助

湖南省自然科学基金(2025JJ70594)