| Part 1 The Diagnostic Value of Multi-parametric MR Imaging for Prostate cancerObjectiveTo investigate the value of 3.OT diffusion weighted imaging(DWI)and dynamic contrast-enhanced(DCE-MRI)in the diagnosis of peripheral zone and central zone of prostate cancer.Method1.A retrospective analysis of 149 cases of prostatic diseases proved by pathology of ultrasound-guided aspiration or surgically analyzed,all patients underwent 3.0T MRI(T1WI,T2WI,DWI,DCE-MRI)examination.Including 63 cases of prostate cancer(49 cases of peripheral zone lesions,38 with central lesion),86 with benign prostatic hyperplasia(BPH),and the apparent diffusion coefficient(ADC)of peripheral lesion and central lesion were measured by post-processing.The time-signal intensity(TIC)curve type difference is statistically significant;The statistical methods were used to analyze the diagnostic efficacy of ADC values and TIC curve types in BPH between with PCa,and to test the consistency of the results.2.According to T2WI,DWI and DCE-MRI,the score of PI-RADS V2 was statistically significant between the two groups.The diagnostic efficacy of PI-RADS V2 in prostatic lesions was analyzed statistically and the results were tested for consistency.Result1.using the ROC curve when the Youden index is maximum,the cutoff value of peripheral zone 's ADC value is 0.995*10-3mm2/s,the sensitivity was 90.2%,the specificity is 89.8%and the accuracy was 90.1%,Youden index was 0.800,the area under the curve was 0.972,the difference between the two groups was statistically significant;ADC value with an outer periphery of the diagnosis of prostate cancer having a high degree of consistency;When the Youden index of the ROC curve is the maximum,the cutoff value of central zone's ADC value is 1.023*10-3mm2/s,the sensitivity was 81.4%,the specificity was 84.2%and the accuracy was 82.3%,the Youden index was 0.656,The area under the curve was 0.886,the difference between the two groups was statistically significant;Central zone ADC value on diagnosis of prostate cancer having a high degree of consistency;The 95%confidence intervals for the ADC values of BPH were for the peripheral zone:(1.393±0.071)and central zone:(1.222±0.044)*10 3mm2/s,respectively.The 95%confidence intervals for the ADC values of PCa were for the peripheral zone:(0.790±0.042)and central zone:(0.856±0.066)*10-3mm2/s;2.In 63 cases of PCa,TIC curve,there are 3 type ?,23 type ?,37 type ?,In 86 cases of BPH,there are 15 type ?,48 type ?,23 type ?.Type ? and ? curves were diagnosed asBPH,and type ? was diagnosed as PCa,The sensitivity,specificity and accuracy were 61.7%,70.8%and 67.1%,respectively.The differences between the two groups were statistically significant.TIC curve type diagnosis of prostate cancer in general;3.In 63 cases of PCa,there are 0 cases of 1 point,1 case of 2 points,7 cases of 3 points,29 cases of 4 points,26 cases of 5 points in PI-RADS V2.In 86 cases of BPH,there are 0 cases of 1 point,39 cases of 2 points,37 cases of 3 points,4 cases of 4 points,0 cases of 5 points in PI-RADS V2.The ROC curve was used to determine the cutoff value of PI-RADS V2 for diagnosis of prostate cancer 3.5,In this study,the scores of 1,2 and 3 were diagnosed as BPH,and the scores of 4 and 5 were diagnosed as PCa.The sensitivity,specificity and accuracy were 84.6%,90.5%and 87.9%,respectively.There was significant difference between the two groups.PI-RADS V2 diagnosis of prostate cancer with a high degree of consistency.Conclusion1.DWI and DCE-MRI have important value in the diagnosis of prostate cancer.2.ADC value has a high diagnostic efficiency in the diagnosis of peripheral and central cancer.3.TIC curve type had no significant value in the diagnosis of prostate cancer.4.PI-RADS V2 has high diagnostic efficacy in the diagnosis of prostate cancerPart 2 Correlation Analysis Between Multi-parametric MR Imaging with Gleason ScoreObjectiveTo investigate the predicted value of apparent diffusion coefficient values?PI-RADS V2 scores in the Gleason score of prostate cancer.MethodsA retrospective analysis of 63 cases of PCa proved by pathology of ultrasound-guided aspiration or surgically analyzed,all patients underwent 3.0T MRI(T1WI,T2WI,DWI,DCE-MRI)examination.Measuring and drawing the ROI of ADC value and TIC curve in the post-processing?PI-RADS V2 scores was obtained by T2WI,DWI and DCE-MRI.According to the Gleason score,PCa was divided into high-grade group(Gleason?7b)and low-grade group(Gleason?7a).1?To analyze the difference of ADC values between the two groups and discuss whether it was statistically significant.Spearman correlation analysis was performed between ADC value and Gleason scores;2?To analyze the difference of PI-RADS V2 scores between the two groups and discuss whether it was statistically significant.Spearman correlation analysis was performed between PI-RADS V2 scores and Gleason scores.ResultIn 63 cases of PCa,there were 33 in the high-grade group(Gleason?7b)and 30 in the low-grade group(Gleason?7a):1.The 95%confidence intervals of ADC values in the high-grade were(0.760 ± 0.049)*10-3mm2/s and the low-grade PCa groups were(0.860 ± 0.061)*10-3mm2/s.ADC value in PCa was negatively correlated with Gleason score(r = 0.-352).2.In the high-level group,there are 0 cases of 1 point,0 cases of 2 points,1 case of 3 points,13cases of 4 points,21 cases of points in PI-RADS V2 score;In the low-level group,there are 1 cases of 2 point,6 cases of 3 points,16 case of 4 points,5 cases of 5 points in PI-RADS V2 Rating?There was a positive correlation between PI-RADS V2 score and Gleason score(r = 0.471).There was statistically significant between the two groups PI-RADS V2 score difference.Conclusion1.The ADC value has a certain predictive value for Gleason score.The lower the ADC value,the higher the probability of Gleason score is,and the higher the malignant level of prostate cancer.2.PI-RADS V2 is helpful to predict Gleason score,and the higher the score,the higher the probability of Gleason score is,and the higher the malignant level of prostate cancer. |
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