Clinical Value Of Dynamic Contrast-enhanced MRI And Diffusion-weighted Imaging On Diagnosis Of Central Gland Prostate Carcinoma

Objective: To study the clinical value of dynamic contrast-enhanced MRI(DCE-MRI)and diffusion-weighted imaging(DWI)on diagnosis of central gland prostate carcinoma(CG-PCa).Methods: A retrospective analysis was performed based on the clinical data of 63 patients who were admitted in the Hospital and confirmed to have prostate gland disease through puncture-biopsy pathological diagnosis.Among these patients,there were 34 cases of PCa and 29 of benign prostatic hyperplasia(BPH).Each patient had received regular MRI,DCE-MRI and DWI scanning.According to the pathological Gleason scores,the 34 patients with PCa were divided into three groups,including the low(GS3+3),moderate(GS 3+4)and high(GS 4+3,4+4,4+5,5+4,5+5)malignancy groups.The DCE-MRI semi-quantitative parameters(TTP,MSI),quantitative parameters(Ktrans,Kep and Ve)and apparent diffusion coefficient(ADC)of two tissues were measured and recorded for comparison.The dynamic parameters were used for ROC curve analysis to calculate the PCa diagnosis susceptibility and specificity and explore the correlations between these parameters and the Gleason score-based malignancy grouping.The correlations between the ADC value and Gleason score-based grouping were assessed by analyzing the differences in ADC values of the three groups with different neoplastic foci and at varied Gleason score-based malignancy degrees.Results: The TTP and MSI values of the BPH patients were both higher than those of the PCa ones(P<0.05).Meanwhile,statistically significant differences were found in the Ktrans,Kep and ADC values between two tissues whereas the differences in the Ve values showed no statistical significance.The largest area of Ktrans under the ROC curve reached 0.823 while that of Kep reached 0.805,with the former presenting the susceptibility and specificity of 82.4% and 67.6% and the latter showing 69% and 89.7%,respectively.In contrast,the Ve value indicated relatively low diagnostic efficiency,with the area under curve(AUC)of 0.559.There were no significant correlations between the dynamic parameters and the Gleason score-based grouping.In the 3 groups of Gleason malignant group,the difference of ADC value between the low moderate group and theheight group was statistically significant(t=8.986,P<0.05),and the analytical results suggested negative correlations between the ADC value and the Gleason score-based grouping.Conclusion: DCE-MRI and DWI have important clinical value in the differential diagnosis of central gland prostate carcinoma,and can display the lesions in CG better.