Diagnostic Efficacy and Imaging Features of Magnetic Resonance Diffusion-Weighted Imaging in the Differential Diagnosis of Benign and Malignant Prostate Hyperplasia
LI Qian, PU Jingze, JIANG Huating, et al
Bazhong Central Hospital, Sichuan Bazhong 636000, China
Abstract：Objective: To explore the efficiency and imaging characteristics of diffusion-weighted imaging (DWI) in the differential diagnosis of benign and malignant prostatic hyperplasia.Methods: A total of 126 patients undergoing routine MRI and DWI examinations in the hospital were retrospectively analyzed between March 2021 and March 2023. DWI characteristics in patients with benign and malignant prostatic hyperplasia were analyzed. The diagnosis results and diagnostic efficiency of routine MRI and DWI for benign and malignant prostatic hyperplasia were compared. According to results of pathological examination, patients were divided into malignant group and benign group, and ADC values of DWI were compared between the two groups. The diagnostic value of ADC for malignant prostatic hyperplasia was analyzed by receiver operating characteristic (ROC) curves. Results: According to pathological examination, there were 89 cases (70.63%) with malignant prostate lesions (prostate cancer) and 37 cases (29.37%) with benign prostate lesions (prostatitis hyperplasia nodules). When diffusion-sensitivity factor (b) was 0, 1000 s/mm2 and 2000 s/mm2, there were equal, slightly high and high signals in central gland, and there were slightly low signals in ADC maps in patients with benign prostatic hyperplasia. In patients with malignant prostatic hyperplasia, there were slightly low, high and bright signals in right central gland and transitional area, and there were significantly low signals in ADC maps. Routine MRI showed that there were 104 cases with malignant prostatic hyperplasia and 22 cases with benign prostatic hyperplasia, and its accuracy, positive predictive value, negative predictive value, sensitivity, specificity and kappa value were 84.92%, 83.65%, 90.91%, 97.75%, 54.05% and 0.588, respectively. DWI showed that there were 94 cases with malignant prostatic hyperplasia and 32 cases with benign prostatic hyperplasia, and its accuracy, positive predictive value, negative predictive value, sensitivity, specificity and kappa value were 91.27%, 91.49%, 90.63%, 96.63%, 78.38% and 0.781, respectively. ADC value in malignant group was significantly lower than that in benign group [(0.91±0.28) ×10-3 mm2/s vs (1.59±0.33) ×10-3 mm2/s; t=11.769, P<0.001]. The area under the curve, optimum critical value, sensitivity and specificity of ADC value in the diagnosis of malignant prostatic hyperplasia were 0.895 (95%CI: 0.836-0.954), 1.20610-3 mm2/s, 86.52% and 78.38%, respectively. Conclusion: Compared with benign prostatic hyperplasia, signals intensity of DWI is significantly increased, while signals in ADC maps are significantly decreased in malignant prostatic hyperplasia. The consistency between DWI and pathological examination is high in the diagnosis of malignant prostatic hyperplasia. ADC has good diagnostic value for malignant prostatic hyperplasia.
李迁, 蒲敬泽, 蒋华庭, 宋建军. 磁共振扩散加权成像鉴别诊断前列腺良恶性增生的效能及影像特点分析[J]. 河北医学, 2024, 30(3): 453-456.
LI Qian, PU Jingze, JIANG Huating, et al. Diagnostic Efficacy and Imaging Features of Magnetic Resonance Diffusion-Weighted Imaging in the Differential Diagnosis of Benign and Malignant Prostate Hyperplasia. HeBei Med, 2024, 30(3): 453-456.
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2024, Vol. 30 
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