Giá trị của định lượng tín hiệu MRI 3.0T trong chẩn đoán ung thư tuyến tiền liệt 1=The value of quantitative 3.0T MRI signal in diagnosing prostate cancer

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Tác giả: Đình Minh Nguyễn, Ngọc Dương Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Nghiên cứu y học (Đại học Y Hà Nội), 2024

Mô tả vật lý: tr.1-8

Bộ sưu tập: Metadata

ID: 244617

Thêm vào giỏ

Nghiên cứu mô tả cắt ngang dựa trên định lượng tín hiệu cộng hưởng từ 3 tesla (MRI 3.0T) để phân biệt ung thư tuyến tiền liệt (UTTTL) và và các tổn thương lành tính. Nghiên cứu trên 84 bệnh nhân có PSA tăng >
4 ng/ml được chụp MRI 3.0 và sinh thiết tuyền tiền liệt qua siêu âm trực tràng có kết quả giải phẫu bệnh, từ tháng 1/2023 - 10/2023 tại Bệnh viện Việt Đức. Kết quả giải phẩu bệnh được xác định là UTTTL khi Gleason ≥ 6 điểm. Vị trí ung thư tuyến tiền liệt được xác định theo phân vùng giải phẫu tương ứng với 2 khu vực trên MRI 3.0T (gồm ngoại vi và vùng trung tâm). Kết quả nghiên cứu cho thấy tuổi trung bình bệnh nhân là 70,1 ± 7,65 tuổi (41 đến 82 tuổi), nhóm ung thư tuyến tiền liệt là 72,6 ± 6,6 tuổi và không ung thư tuyến tiền liệt là 67,7 ± 8,2 tuổi (p <
0,01). Xem xét tổn thương ở cả vùng ngoại vi và vùng trung tâm, các chỉ số tín hiệu tổn thương của ung thư tuyến tiền liệt là luôn thấp hơn nhóm lành tính trên T2W (T2W mean), ADC (ADCmean và ADCmin), trong khi chỉ số trên DWI (DWImean và DWImax) là cao hơn (p <
0,01). Mặt khác, đường cong ROC thể hiện khả năng chẩn đoán ung thư tuyến tiền liệt cho thấy chỉ số ADCmean là chính xác nhất với diện tích dưới đường cong (AUC) là 0,948, độ nhạy (Sn) 92,3% và độ đặc hiệu (Sp) 86,7% ở vùng ngoại vi và AUC 0,991 ở vùng trung tâm với Sn 97,4% và Sn 86,7%. Bên cạnh đó, các chỉ số ADCmin, T2mean, DWImean, DWImax cũng có giá trị cao trong chẩn đoán ung thư tuyến tiền liệt.This cross-sectional descriptive study based on quantitative signal intensity on 3-tesla magnetic resonance imaging (3.0T MRI) was conducted to differentiate prostate cancer (PCa) and non prostate cancer (NPCa) lesions. The study involved 84 patients (PTs) with PSA >
4 ng/ml who underwent 3.0T MRI and transrectal ultrasound-guided prostate biopsy with histopathological results from January to October 2023 at Viet Duc Hospital. The histopathological result was defined as PCa when Gleason score was ≥ 6. The location of PCa was determined based on anatomical zones corresponding to 2 regions on 3.0T MRI (peripheral or central zone). The results showed the mean age was 70.1 ± 7.65 years (ranging from 41 to 82 years), PCa group was 72.6 ± 6.6 years, and NPCa group was 67.7 ± 8.2 years (p <
0.01). Considering lesions in both peripheral and central zones, the signal intensity indices of PCa were consistently lower than the benign group on T2-weighted images (T2W mean), apparent diffusion coefficient (ADC mean and ADC min), while indices on diffusion-weighted imaging (DWI mean and DWI max) were higher (p <
0.01). Moreover, the ROC curve demonstrated that ADC mean was the most accurate in diagnosing PCa with an area under the curve (AUC) of 0.948, sensitivity (Sn) of 92.3%, and specificity (Sp) of 86.7% in the peripheral zone and AUC of 0.991 in the central zone with Sn 97.4% and Sn 86.7%. Additionally, ADC min, T2 mean, DWI mean, DWI max also had high diagnostic value in detecting PCa.

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