Prostate dynamic contrast-enhanced MRI with simple visual diagnostic criteria:: is it reasonable?
Prostate dynamic contrast-enhanced MRI with simple visual diagnostic criteria:: is it reasonable?
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DOI：
10.1007/s00330-006-0478-9
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发表时间：
2007-06-01
影响因子：
5.9
通讯作者：
Rouviere, Olivier
中科院分区：
文献类型：
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作者：
Girouin, Nicolas;Mege-Lechevallier, Florence;Rouviere, Olivier
本研究的目的是评估前列腺癌定位的准确性与简单的视觉诊断标准，使用动态对比增强（DCE）磁共振成像（MRI）。共有46例经活检证实的前列腺癌患者在前列腺切除术前接受了前列腺1.5 T MRI和盆腔相控阵线圈。除了常规的T2加权序列外，在注射钆特酸盐后采集3次30 s DCE序列。在DCE图像上，所有周围区的早期增强病变都被认为是恶性的。在中央腺体，只有早期增强的病灶表现为均匀或侵犯周边区被认为是恶性的。三名阅片人详细说明了20个前列腺扇区中存在癌症以及不同肿瘤的位置。将结果与组织学进行比较; p < 0.05被认为是显著的。对于肿瘤在扇形区的定位，DCE成像具有显著更高的灵敏度[逻辑回归，比值比（OR）：3.9，p < 0.0001]和轻微但显著更低的特异性（OR：0.57，p < 0.0001）。在> 0.3 cc的肿瘤中，T2加权和DCE成像分别正确显示了50-60%和78-81%。对于这两种技术，> 0.3 cc的肿瘤的显示率受到Gleason评分的显著影响（大多数Gleason评分都是由肿瘤的大小决定的）。
The purpose of this study was to evaluate the accuracy of prostate cancer localization with simple visual diagnostic criteria using dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI). A total of 46 consecutive patients with biopsy-proven prostate cancer underwent prostate 1.5 T MRI with pelvic phased-array coils before prostatectomy. Besides the usual T2-weighted sequences, a 30-s DCE sequence was acquired three times after gadoterate injection. On DCE images, all early enhancing lesions of the peripheral zone were considered malignant. In the central gland, only early enhancing lesions appearing homogeneous or invading the peripheral zone were considered malignant. Three readers specified the presence of cancer in 20 prostate sectors and the location of distinct tumors. Results were compared with histology; p < 0.05 was considered significant. For localization of cancer in the sectors, DCE imaging had a significantly higher sensitivity [logistic regression, odds ratio (OR): 3.9, p < 0.0001] and a slightly but significantly lower specificity (OR: 0.57, p < 0.0001). Of the tumors > 0.3 cc, 50-60% and 78-81% were correctly depicted with T2-weighted and DCE imaging, respectively. For both techniques, the depiction rate of tumors > 0.3 cc was significantly influenced by the Gleason score (most Gleason