Abstract:

Objective　To explore the clinical significance of MRI functional imaging combined with serology in distinguishing the nature of prostate lesions. Methods　A retrospective study was conducted on 120 suspected prostate cancer (PCa) patients admitted to Yan'an People's Hospital from July 2021 to July 2023, all male. All patients underwent routine 3.0T MRI scan, diffusion-weighted imaging (DWI), magnetic resonance spectroscopy (MRS), and pathological examination. Based on the pathological results, the patients were divided into a PCa group (53 cases) and a benign group (67 cases). The age of the PCa group was (63.19±4.72) years old, while the age of the benign group was (61.75±4.54) years old. Serum free prostate-specific antigen (fPSA) levels, total prostate-specific antigen (tPSA) levels, MRI functional imaging results, pathological results, and diagnostic efficacies of different examination methods were compared between the two groups. Independent sample t test and χ² test were used. Results　The serum levels of fPSA and tPSA in the PCa group were higher than those in the benign group (both P<0.05). The diagnostic sensitivity of routine MRI scanning was 69.81% (37/53), the specificity was 83.58% (56/67), and the accuracy was 77.50% (93/120). The diagnostic sensitivity of DWI was 75.47% (40/53), the specificity was 88.06% (59/67), and the accuracy was 82.50% (99/120). The diagnostic sensitivity of MRS was 73.58% (39/53), the specificity was 86.57% (58/67), and the accuracy was 80.83% (97/120). The diagnostic sensitivity of serology was 71.70% (38/53), the specificity was 86.57% (58/67), and the accuracy was 80.00% (96/120). The diagnostic sensitivity of their combination was 94.34% (50/53), the specificity was 83.58% (56/67), and the accuracy was 88.33% (106/120). The sensitivity and positive predictive value of combined diagnosis were higher than those of functional MRI imaging and serology alone, and the missed diagnosis rate was lower than that of functional MRI imaging and serology alone (all P<0.05). Conclusion　MRI functional imaging combined with serology has certain diagnostic value for PCa and can serve as an effective diagnostic method for distinguishing the nature of prostate lesions in clinical practice.

Key words:

Prostate lesions, MRI functional imaging, Free prostate specific antigen, Total prostate specific antigen

摘要：

目的　探讨MRI功能成像联合血清学对鉴别前列腺病变性质的临床意义。方法　回顾性选取2021年7月至2023年7月延安市人民医院收治的疑似前列腺癌（PCa）患者120例，均为男性，均行3.0T MRI常规扫描、弥散加权成像（DWI）扫描、磁共振波谱（MRS）成像扫描及病理检查。根据病理结果，将患者分为PCa组（53例）及良性组（67例）。PCa组年龄（63.19±4.72）岁，良性组年龄（61.75±4.54）岁。比较两组血清游离前列腺特异性抗原（fPSA）水平、总前列腺特异性抗原（tPSA）水平、MRI功能成像结果、病理结果及不同检查方式的诊断效能。采用独立样本t检验和χ²检验。结果　PCa组血清fPSA、tPSA水平均高于良性组（均P<0.05）；MRI常规扫描诊断灵敏度为69.81%（37/53）、特异度为83.58%（56/67）、准确率为77.50%（93/120），DWI诊断灵敏度为75.47%（40/53）、特异度为88.06%（59/67）、准确率为82.50%（99/120），MRS诊断灵敏度为73.58%（39/53）、特异度为86.57%（58/67）、准确率为80.83%（97/120），血清学诊断灵敏度为71.70%（38/53）、特异度为86.57%（58/67）、准确率为80.00%（96/120），联合诊断灵敏度为94.34%（50/53）、特异度为83.58%（56/67）、准确率为88.33%（106/120）；联合诊断灵敏度、阳性预测值均高于MRI功能成像、血清学单独应用，漏诊率低于MRI功能成像、血清学单独应用（均P<0.05）。结论　MRI功能成像联合血清学对PCa具有一定诊断价值，可作为临床鉴别前列腺病变性质的有效检查方式。

关键词:

前列腺病变, MRI功能成像, 游离前列腺特异性抗原, 总前列腺特异性抗原