| BackgroundBenign prostatic hyperplasia?BPH?and Prostate cancer?PCa?is a common urogenital disease in elderly men.In recent years,with the intensification of aging population in our country,people eating behavior structure changes,the popularity of prostate disease screening and diagnosis level unceasing enhancement,the incidence of Benign prostatic hyperplasia and prostate cancer earlier have obvious rising trend,prostatic hyperplasia and prostate cancer is becoming a serious threat to the quality of life and health of the urinary system disease in older men.Magnetic resonance imaging?MRI?can provide important evidence for the clinical diagnosis and staging of prostate cancer because of its high resolution of soft tissue and its advantages of multi-parameter,multi-sequence and multi-direction imaging.Currently,it is considered to be one of the most ideal examination methods for prostate diseases.With the upgrade of mri equipment,the improvement of technology,and the abundance of functional imaging methods,mri examination can provide more basis for the diagnosis and grading of prostate cancer,and improve the detection rate of prostate disease.Diffusion tensor imaging?DTI?is based on DWI,which is applied to the diffusion sensitive gradient field of multiple?6-55,theoretically more?nonlinear direction,and the diffusion image obtained by the post-processing acquisition.It can be used to describe the diffusion direction characteristics of water seeds and the distribution of water in the tissue,which can be used to evaluate the microstructure of the tissue structure.The main commonly used clinical parameters are apparent diffusion coefficient?ADC??fractional anisotropy?FA??diffusion tensor tractography?DTT?.In recent years,the diagnosis of prostate disease has become a hot topic.However,the research achievements of different institutions at home and abroad have not been unified and disputed.PurposeThis study aims to study the diagnosis of prostatic hyperplasia and prostate cancer by3.0T magnetic resonance DTI,and the correlation between 3.0T magnetic resonance diffusion and the gleason score of prostate cancer.The diagnostic value of prostate cancer is discussed.Materials and MethodsFrom September 2016 to September 2017,a retrospective analysis was conducted on65 cases of patients who were admitted to our hospital with clinical symptoms such as frequent urination,urgency,dysuria and nocturia and planned to receive surgical treatment.All patients received surgical treatment or ultrasound-guided puncture after examination,and pathological results were obtained.The mean age was?65±7?years and ranged from?53-81?years.Postoperative pathology or ultrasonography confirmed that there were 27patients in the prostate hyperplasia group and 38 patients in the prostate cancer group.To analyze whether the DTI parameters of prostate cancer group and prostate hyperplasia group were statistically significant.Patients in the prostate cancer group were divided into three groups according to their pathological Gleason score?7 cases in the high group:Gleason score>8;17 cases in the group:Gleason score=7;14 cases in the low group:Gleason score was less than or equal to 6?,and the correlation between DTI parameters and Gleason score of prostate cancer was analyzed and compared.Results1.FA values in the prostate cancer group and the prostate hyperplasia group were0.310±0.087 and 0.231±0.029,respectively.FA values in the prostate cancer group were higher than those in the hyperplasia group,and there was a significant difference between the two groups?t=4.578.P<0.05?.The ADC values of the prostate cancer group and the prostate hyperplasia group were?0.986±0.144?10-3mm2/s and?1.438±0.198?10-3mm2/s,respectively.?t=-10.66;P<0.05?.2.According to the ROC curve,the area under the FA value curve is 0.827.According to the Youden index,when the FA value is 0.274,the sensitivity is 86%and the specificity is 64%.The 95%confidence interval ranged from 0.719 to 0.934.Figure 4:according to the ROC curve,the area under the ADC value curve is 0.948.According to the Youden index,when the ADC value is 1.202 10-3mm2/s,the sensitivity is 89%and the specificity is 76%.The 95%confidence interval ranged from 0.752 to 0.941.3.FA values of the high-risk,medium-risk and low-risk prostate cancer Gleason score were 0.444±0.052,0.323±0.022and 0.227±0.048,respectively,with statistically significant differences among the groups?F=73.153,P<0.05?,and statistically significant differences between the two groups?P<0.05?.FA value was positively correlated with Gleason score?r=0.934,P<0.05?.In other words,as Gleason score increased,FA value increased and decreased.The ADC values of the high-risk,medium-risk and low-risk groups of prostate cancer Gleason score were?0.769±0.053?10-3mm2/s,?0.959±0.065?10-3mm2/s,?1.128±0.067?10-3mm2/s,respectively.The differences were statistically significant?F=76.993,P<0.05?,and the differences between the two groups were statistically significant?P<0.05?.There was a negative correlation between ADC and Gleason score?r=0.876,P<0.05?.In other words,with the increase of Gleason score,the ADC value decreases and vice versa.ConclusionDTI parameters can reflect the microscopic difference of prostate tissue,provide quantitative diagnostic information,and provide certain diagnostic clues for the diagnosis of prostate cancer,which can be used to evaluate the classification and prognosis of prostate cancer. |
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