[1]周亚芬,赵旖旎,邱伟,等.DCE-MRI联合DWI在前列腺良恶性病变诊断中的应用价值[J].中国医学物理学杂志,2026,43(3):300-307.[doi:DOI:10.3969/j.issn.1005-202X.2026.03.004]
　ZHOU Yafen,ZHAO Yini,QIU Wei,et al.Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging combined with diffusion-weighted imaging in benign and malignant prostate lesions[J].Chinese Journal of Medical Physics,2026,43(3):300-307.[doi:DOI:10.3969/j.issn.1005-202X.2026.03.004]
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DCE-MRI联合DWI在前列腺良恶性病变诊断中的应用价值()

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
43卷
期数:
2026年第3期
页码:
300-307
栏目:
医学影像物理
出版日期:
2026-03-27

文章信息/Info

Title:
Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging combined with diffusion-weighted imaging in benign and malignant prostate lesions
文章编号:
1005-202X（2026）03-0300-08
作者:
周亚芬1; 赵旖旎2; 邱伟1; 娄彦亭3
1.安徽医科大学附属巢湖医院放射科， 安徽 巢湖 238000； 2.安徽医科大学附属巢湖医院磁共振室， 安徽 巢湖 238000； 3.安徽医科大学附属巢湖医院泌尿外科， 安徽 巢湖 238000
Author(s):
ZHOU Yafen1;  ZHAO Yini2;  QIU Wei1;  LOU Yanting3
1. Department of Radiology, Chaohu Hospital Affiliated to Anhui Medical University, Chaohu 238000, China 2. Magnetic Resonance Room, Chaohu Hospital Affiliated to Anhui Medical University, Chaohu 238000, China 3. Department of Urology, Chaohu Hospital Affiliated to Anhui Medical University, Chaohu 238000, China
关键词:
磁共振成像; 增强成像; 高分辨率; 扩散加权成像; 前列腺癌
Keywords:
Keywords: magnetic resonance imaging enhanced imaging high resolution diffusion-weighted imaging prostate cancer
分类号:
R816.7
DOI:
DOI:10.3969/j.issn.1005-202X.2026.03.004
文献标志码:
A
摘要:
目的：分析高分辨率磁共振动态增强成像（DCE-MRI）与扩散加权成像（DWI）在前列腺良恶性病变诊断中的联合应用价值。方法：回顾性收集2022年1月~2024年11月安徽医科大学附属巢湖医院收治的82例前列腺病变患者临床资料，所有患者病理检查前均接受DCE-MRI、DWI检查，以病理检查结果为金标准，比较良性病变与恶性病变患者DCE-MRI、DWI影像特征、表观弥散系数值（ADC）及信号强度-时间（SI-T）曲线类型的差别，分析DCE-MRI、DWI单独及联合检测对前列腺良恶性病变的诊断价值。结果：病理检查结果显示，82例前列腺病变患者中恶性病变31例（37.80%），良性病变51例（62.20%）。与良性病变患者相比，恶性病变患者DWI的ADC值较小，DCE-MRI的SI-T曲线类型中Ⅲ型占比较高，病灶位置位于外周区的占比较高（P<0.05）。ROC曲线显示，DWI的ADC值诊断前列腺良恶性病变的曲线下面积为0.906（95%CI：0.841~0.971），当ADC值取14.73×10-4 mm2/s时，敏感度、特异度及约登指数分别为84.30%、83.90%、0.682。DWI、DCE-MRI单独及联合诊断前列腺良恶性病变与病理诊断结果一致性均理想，且联合诊断与病理诊断结果的一致性更强（Kappa值=0.632、0.677、0.898）；与DWI、DCE-MRI单独诊断相比，二者联合诊断前列腺良恶性病变的准确度、敏感度及阴性预测值均更高（P<0.05）。通过Logistic逻辑回归分析验证得到ADC值、SI-T曲线类型预测前列腺良恶性病变的逻辑回归模型：Logit(P)=-35.716-0.576×ADC值+2.135×SI-T曲线类型，ROC曲线分析显示，ADC值、SI-T曲线类型结合构成的回归模型鉴别前列腺良恶性病变AUC为0.967（95%CI：0.927~1.000），特异度、敏感度、约登指数分别为：0.980、0.871、0.851。结论：在本单中心回顾性研究中，DWI的ADC值与DCE-MRI的SI-T曲线类型联合应用可提升前列腺良恶性病变鉴别效能，诊断准确度、敏感度与阴性预测值均有提高。但结论基于单中心回顾性数据，需前瞻性大样本研究验证，以增强临床适用性。
Abstract:
Abstract: Objective To analyze the application value of high-resolution dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with diffusion-weighted imaging (DWI) in the diagnosis of benign and malignant prostate lesions. Methods A retrospective analysis was conducted on the clinical data of 82 patients with prostate lesions who were admitted to Chaohu Hospital Affiliated to Anhui Medical University from January 2022 to November 2024. All patients underwent DCE-MRI and DWI before pathological examination. Taking pathological results as the gold standard, the differences in DCE-MRI and DWI imaging characteristics, apparent diffusion coefficient (ADC) values, and signal intensity-time (SI-T) curve types were compared between patients with benign and malignant lesions. Additionally, the diagnostic performance of DCE-MRI and DWI, alone and in combination, for differentiating benign and malignant prostate lesions was evaluated. Results Pathological findings revealed that among the 82 patients with prostate lesions, 31 (37.80%) had malignant lesions and 51 (62.20%) had benign lesions. Compared with patients with benign lesions, those with malignant lesions exhibited a lower ADC value on DWI, a higher proportion of type III on the SI-T curve type of DCE-MRI, and a higher frequency of lesions located in the peripheral area (P<0.05). ROC curve analysis demonstrated that the area under the curve (AUC) of DWI-derived ADC value for diagnosing benign and malignant prostate lesions was 0.906 (95% CI: 0.841-0.971). At an ADC value of 14.73×10-4 mm2/s, the sensitivity, specificity and Youden index were 84.30%, 83.90% and 0.682, respectively. DWI and DCE-MRI, both alone and in combination, exhibited favorable consistency with the pathological diagnosis of benign and malignant prostate lesions, with the combined modality showing a higher consistency with pathological results (Kappa value=0.632, 0.677, 0.898, respectively). Compared with DWI and DCE-MRI alone, the combined modality achieved higher accuracy, sensitivity and negative predictive value for the diagnosis of benign and malignant prostate lesions (P<0.05). Logistic regression model was established to predict the malignancy of prostatic lesions using ADC values and SI-T curve types: Logit(P)=-35.716-0.576×ADC value+2.135×SI-T curve type. ROC curve analysis showed that the regression model constructed with ADC value and SI-T curve type had an AUC of 0.967 (95% CI: 0.927-1.000) for differentiating benign from malignant prostatic lesions, with a specificity, sensitivity, and Youden index of 0.980, 0.871, and 0.851, respectively. Conclusion This single-center retrospective study demonstrates that the combination of DWI-derived ADC values and DCE-MRI-derived SI-T curve types enhances the diagnostic performance of differentiating benign from malignant prostatic lesions, with improved diagnostic accuracy, sensitivity, and negative predictive value. However, these findings are based on single-center retrospective data and require further validation through prospective, large-sample researches to strengthen their clinical applicability.

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备注/Memo

备注/Memo:
【收稿日期】2025-11-23 【基金项目】安徽省卫生健康科研项目（AHWJ2024BAc20005） 【作者简介】周亚芬，主治医师，研究方向：泌尿生殖系统疾病的影像诊断，E-mail: 18356516870@163.com 【通信作者】娄彦亭，硕士，主任医师，研究方向：泌尿系肿瘤、泌尿系结石，E-mail: louyanting@ahmu.edu.cn
更新日期/Last Update: 2026-03-27