Study On The Value Of High B Value MRI Combined With Multiphase Dynamic Enhancement In The Diagnosis Of Prostate Cancer

Objective:To explore the diagnostic value of high-b value DWI combined with multi-phase dynamic enhanced scanning for benign and malignant nodules of the prostate.Methods:A total of 60 patients with prostate nodules admitted to our hospital from January 2017 to October 2020 were collected.They were routinely performed MRI scan,diffusion,and multi-phase dynamic examination.The average signal intensity of the nodules and the same layer of gluteus maximus were measured.Calculate the T₁,T₂signal intensity ratio(SIR_T1,SIR_T2)of each prostate nodule separately from the average signal intensity,measure the apparent diffusion coefficient ADC value of the prostate nodule（b=1500s/mm²）,and plot the multi-phase dynamics of the prostate nodule Enhance the time-signal intensity curve（TIC）.According to the postoperative or puncture pathological results,they were divided into prostate cancer（group A）and prostate hyperplasia（group B）.Among them,there were 36 patients in group A and 24 patients in group B.1.Analyze the diagnostic value of the combined application of SIR and ADC values in the two groups of patients,and evaluate its diagnostic efficacy;2.Analyze the diagnostic value of the combined application of SIR_T2value,ADC value and PSA value in the two groups of patients,and evaluate its diagnostic efficacy;3.Analyze the diagnostic value of the combined application of ADC value,PSA value and DCE-MRI curve type in the two groups of patients,and evaluate its diagnostic efficacy;4.Analyze the diagnostic value of the combined application of SIR_T2value,ADC value and DCE-MRI curve type in the two groups of patients,and evaluate its diagnostic efficacy.Result:1.Combined application of SIR and ADC values:The SIR_T1value of the prostate cancer group was higher than that of the prostate hyperplasia group（t=0.464,p=0.606,p>0.05）;the ADC value of the prostate cancer group was significantly lower than that of the prostate hyperplasia group（t=-8.688,p<0.001）.The sensitivity,specificity,positive predictive value,and negative predictive value of the two combined diagnosis of prostate nodules were:94.1%,61.5%,76.2%,88.9%,respectively;the SIR_T2value of the prostate cancer group was higher than that of the prostate hyperplasia group（t=-0.2434,p=0.018,p<0.05）,the ADC value of the prostate cancer group was significantly lower than that of the prostate hyperplasia group（t=-8.688,p<0.001）;the sensitivity,specificity,positive predictive value,and negative of the combined diagnosis of prostate nodules The predicted values are:94.1%,61.5%,76.2%,88.9%.2.Combined application of SIR_T2value,ADC value and PSA value:The SIR_T2value of the prostate cancer group is higher than that of the prostate hyperplasia group（non-parametric test,p=0.031,p<0.05）;the ADC value of the prostate cancer group is significantly lower than that of the prostate hyperplasia group（t=-3.245,p=0.002,p<0.05）;the PSA value of the prostate cancer group was significantly higher than that of the prostate hyperplasia group（p<0.001）.The sensitivity,specificity,positive predictive value,and negative predictive value of the combined application of the three are:86.2%,76.9%,80.6%,and83.3%,respectively.3.Combined application of ADC value,PSA value and DCE-MRI curve type:ADC value of prostate cancer group was significantly lower than that of prostate hyperplasia group（t=-3.656,p=0.001,p<0.05）;PSA value of prostate cancer group was significantly higher Prostatic hyperplasia group（p<0.001）;TIC curve composition ratio of the two groups of patients,28 cases of outflow curve in prostate cancer group,17 cases of inflow curve of prostate hyperplasia,（X²=39.787,p<0.001）.The sensitivity,specificity,positive predictive value,and negative predictive value of the combined application of the three are:96.6%,92.3%,93.3%,and 96.0%,respectively.4.Combined application of SIR_T2value,ADC value and DCE-MRI curve type:The SIR_T2value of the prostate cancer group is lower than that of the prostate hyperplasia group（p=0.248,p>0.05）;the ADC value of the prostate cancer group is significantly lower than that of the prostate hyperplasia group（t=-3.656,p=0.001,p<0.05）;the TIC curve of the two groups of patients:the outflow curve in the prostate cancer group accounted for 70.8%;the inflow type of prostate hyperplasia accounted for 70.8%,（X²=42.989,p<0.001）.The sensitivity,specificity,positive predictive value,and negative predictive value of the combined application of the three are:96.6%,92.3%,94.3%,and 96.0%,respectively.Conclusion:Multi-parameter MRI（T₂WI,DWI combined with multi-phase dynamic enhancement scan）has important value in the differential diagnosis of benign and malignant prostate nodules.