Objective To explore the value of 3.0T multi-parameter
magnetic resonance imaging (Mp-MRI), namely T2 weighted imaging (T2WI) combined
with diffusion weighted imaging (DWI) and dynamic contrast enhancement (DCE) in
the diagnosis and differential diagnosis of chronic prostatitis (CP) of
peripheral zone. Methods The Mp-MRI data of 23 patients with CP of peripheral zone and 38
patients with prostate cancer (PCa) of peripheral zone who underwent prostate
Mp-MRI examination and were pathologically confirmed in The First Affiliated
Hospital of Guangdong Pharmaceutical University from July 2016 to December 2021
were retrospectively analyzed. The age of the CP group was (64.3±7.8) years
old, and that of the PCa group was (73.7±8.5) years old. According to the
pathological results and the lesion range of peripheral zone of prostate on
Mp-MRI, all the selected cases were subdivided into four subgroups: diffuse CP
(CP1), focal CP (CP2), diffuse PCa (PCa1), and focal PCa (PCa2). One way ANOVA
or independent sample t-test was used
to compare the differences of apparent diffusion coefficient (ADC) values among
normal tissues, CP, and PCa in the peripheral zone and among subgroups of CP
and PCa. Fisher's exact test was used to compare the distribution of signal
intensity-time (SI-T) curve types among CP, PCa, and their subgroups. The
receiver operating characteristic curve (ROC) was used to evaluate the
diagnostic efficacy of ADC value in diagnosing CP of peripheral zone and
determine the optimal cut-off value. The sensitivity, specificity, and accuracy
of Mp-MRI (T2WI+DWI-ADC+DCE) in the diagnosis of CP were calculated. Results Among the 23
cases of CP, there were 16 cases in the CP1 subgroup and 7 cases in the CP2
subgroup; among the 38 cases of PCa, there were 21 cases in the PCa1 subgroup
and 17 cases in the PCa2 subgroup. There was a statistically significant
difference in the ADC value among CP of peripheral zone, PCa, and normal
tissues [(1.15±0.23) ×10-3 mm2/s vs. (0.85±0.28) ×10-3 mm2/s vs. (1.54±0.19) ×10-3 mm2/s] (F=14.27, P<0.01). There was a statistically significant difference in the
ADC value among CP1, CP2, PCa1, and PCa2 subgroups [(1.17±0.11) ×10-3 mm2/s vs. (1.10±0.18) ×10-3 mm2/s vs.
(0.81±0.17) ×10-3 mm2/s vs. (0.89±0.21) ×10-3 mm2/s] (F=9.76, P<0.01). There were statistically
significant differences in the ADC value between the CP group and the PCa group
[(1.15±0.23) ×10-3 mm2/s vs. (0.85±0.28) ×10-3 mm2/s], between the CP1 subgroup and the PCa1 subgroup [(1.17±0.11)
×10-3 mm2/s vs. (0.81±0.17) ×10-3 mm2 /s], between the CP2 subgroup and the PCa2 subgroup [(1.10±0.18) ×10-3 mm2/s vs. (0.89±0.21) ×10-3 mm2/s] (t=4.23, 7.48, and 2.31; all P<0.05). There were no statistically
significant differences in the ADC value between the CP1 subgroup and the CP2
subgroup, between the PCa1 subgroup and the PCa2 subgroup (t=1.16 and 1.30; all P>0.05).
Taking ADC value >1.02×10-3 mm2/s as the diagnostic
criteria for CP, the sensitivity, specificity, and accuracy were 86.96%,
89.47%, and 88.52% respectively. There were statistically significant
differences in the distribution of DCE SI-T curve types between the CP group
and the PCa group, between the CP1 subgroup and the PCa1 subgroup, between the
CP2 subgroup and the PCa2 subgroup (all P<0.01).
Compared with the surgical pathology, the sensitivity, specificity, and
accuracy of Mp-MRI (T2WI+DWI-ADC+DCE) in the diagnosis of CP of peripheral zone
were 91.30%, 92.11%, and 91.80%, respectively. Conclusion Mp-MRI has a high diagnostic efficiency for
CP of peripheral zone, and can more accurately distinguish CP from PCa, which
can be used as an important method for non-invasive diagnosis of CP of peripheral
zone.
