The Study Of Growth And Development Of Normal Prostate In3.0T MRI And DWI, DCE-MRI In The Diagnosis Of Prostatic Diseases

Objective：1. To retrospective study the prostate volume of normal children and adolescents andto evaluate the development of prostate central zone and peripheral zone. To provide thepreliminary MRI standards of prostate growth and development for normal Chinesechildren and adolescents.2. To study the significance of the ADC value and the quantitative analysisparameters of DCE-MRI in the diagnosis of prostate cancer and to correlate ADC andK^transwith Gleason score.Methods：1.627healthy male volunteers, aged from2-25years were retrospectively analysed.They were divided into five groups by the ages （group A:2-5years, group B:6-10years,group C:11-15years, group D:16-20years and group E:21-25years）. All the volunteersunderwent conventional MRI examinations at our institution （T2WI Axial and coronalimage acquisition）. The prostate volume of different age groups were measured, thedevelopment of the central zone and peripheral zone were scored by two radiologists, and the data was treated by Nonparametric test. Statistical significance was inferred at P<0.05.2.40patients confirmed by pathology were performed conventional MR imaging,DWI and DCE-MR examinations, and divided into cancerous foci, noncancerous foci inthe peripheral zone and central gland. ROI were drawn on areas of prostate tissue tomeasure the values of ADC, K^trans, v_e and k_ep. The values of the four parameters indifferent groups were compared with ANOVA．The correlations between the ADC andK^transwith Gleason score were assessed with Pearson correlation.Results：1. Group A prostate nearly not development, only individual MRI measurable its size;Group B most not development, only six children visible prostate form, but can’tdistinguish the anatomical division; Group C prostate gland development better, MRI canmeasure the size, but distinguish its central and peripheral area is difficult; Group Dprostate gland development rapidly, differences are obvious, but only a few central andperipheral area boundary clear; Group E the central and peripheral area boundary clear,form full, T2WI signal contrast clear. The median prostate volumes of group A, B, C, Dand E were0.00cm3、0.00cm3、2.45cm3、7.99cm3and10.60cm3, respectively. The medianprostate scores of group A, B, C, D and E were0.04、0.31、1.34、2.23and2.60. Theprostate volumes were significant difference among these five groups （P=0.000）. Therewere significant difference among the volumes and the scores of these five groups（P<0.05）.2. The ADC values of cancerous foci, noncancerous foci in the peripheral zone andnoncancerous foci in the central gland were （0.79±0.13）×10-3mm2/s,（1.18±0.26）×10-3mm2/s and （1.03±0.22）×10-3mm2/s, respectively. The differences between ADC value ofthe three groups was statistically significant （F=33.765, P<0.05）; Significant correlationwas found between ADC value and G1eason score （r=-0.555, P<0.05）.3. The K^trans, v_e and k_epvalues of cancerous foci were （0.62±0.10）/min,（0.44±0.12）and （1.45±0.25）/min, respectively, while,（0.21±0.06）/min,（0.29±0.65）,（0.76±0.21）/minfor noncancerous foci in the peripheral zone,（0.32±0.09）/min,（0.34±0.70）,（0.95±0.26）/min for noncancerous foci in the central gland, respectively. The differences between K^trans, v_e and k_epvalues of the three groups were statistically significant（F=234.338,32.593and92.462, respectively; P<0.05）. Significant correlation was foundbetween K^transand G1eason score （r=0.533，P<0.05）.Conclusion：1. Magnetic resonance multi-dimensional imaging provided the basis of objective andtruth for the measurements of volume and the observations of prostate development in thisstudy, which offers preliminary reference range for normal Chinese children andadolescents prostate development status.2. The differences of ADC, K^trans, v_e and k_epvalues among the three groups （cancerousfoci, noncancerous foci in the peripheral zone and central gland） were statisticallysignificant;3.0T DWI and DCE-MRI Quantitative analysis have a high value in thediagnosis of prostate cancer.3. Significant correlations were found between ADC, K^transand G1eason score;Prompted ADC value and DCE quantitative parameter K^transcan be used for evaluating thedegree of malignancy for prostate cancer.