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| 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 |
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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.
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[1] 李帅,汪继红,俞建军.经膀胱途径腹腔镜根治性前列腺切除术对性功能和尿控功能的影响[J].中华泌尿外科杂志,2021,42(10):778-779.
[2] Matsukawa Y,Funahashi Y,Ishida S,et al.Clinical features and urodynamic findings in elderly men with chronic prostatitis[J].Int Urol,2022,29(5):441-445.
[3] Xing P,Chen L,Yang Q,et al.Differentiating prostate cancer from benign prostatic hyperplasia using whole-lesion histogram and texture analysis of diffusion- and T2-weighted imaging[J].Cancer Imaging,2021,21(1):54-64.
[4] 李梦思,李文政.定量功能磁共振成像技术在前列腺癌中的临床应用及进展[J].中南大学学报(医学版),2021,46(4):414-420.
[5] Schaeffer E,Srinivas S,Antonarakis E S,et al.NCCN guidelines insights:prostate cancer,version 1.2021[J].Natl Compr Canc Netw,2021,19(2):134-143.
[6] 孙浩瑜,姜鑫,陈守臻,等.多参数磁共振联合前列腺健康指数对PSA灰区临床有意义前列腺癌的诊断价值[J].山东大学学报(医学版),2022,60(6):46-50.
[7] Meyer HJ,WIenke A,Surov A.Diffusion-weighted imaging of different breast cancer molecular subtypes:a systematic review and meta-analysis[J].Breast Care (Basel),2022,17(1):47-54.
[8] 郭晓,邓喜青,胡振,等.3.0T磁共振多模态成像技术在鉴别前列腺良恶性病变的诊断价值[J].中国CT和MRI杂志,2023,21(2):129-130,136.
[9] Hectors SJ,Said D,Gnerre J,et al.Luminal water imaging:comparison with diffusion-weighted imaging (DWI) and PI-RADS for characterization of prostate cancer aggressiveness[J].Magn Reson Imaging,2020,52(1):271-279.
[10] 李鹏,黄英,李艳,等.DWI和DCE-MRI鉴别诊断良恶性前列腺外周带T2WI局灶性低信号病变[J].中国介入影像与治疗学,2021,18(3):156-160. |
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2024, Vol. 30 
