中文摘要：

目的 探讨分段读出扩散加权成像（RESOLVE）序列ADC值鉴别前列腺癌和良性前列腺增生的价值.方法 回顾性分析经超声引导下直肠穿刺活检病理证实、行前列腺MRI检查（T1WI、T2WI及RESOLVE序列）,且MRI检查前未进行过穿刺活检、内分泌治疗或放射治疗的72例患者纳入研究.将患者分为2组：前列腺癌组23例（43个病灶）和前列腺增生组49例（64个病灶）.患者均行前列腺MR检查.由2名医师先采用双盲法独立对图像进行评估,并采用组内相关系数（ICC）值和Bland-Altman图,分析2名观察者测量ADC值的一致性.计算2名医师测量RESOLVE序列ADC值的平均值,并采用独立样本t检验比较前列腺癌组和前列腺增生组ADC值的差异.以病理结果为金标准,绘制ADC值诊断前列腺癌的ROC曲线,判断最佳诊断界值点,计算ADC值诊断前列腺癌的敏感度、特异度和准确度.结果 2名观察者测量ADC值的一致性好（ICC=0.976,P＜0.01）.前列腺癌组的ADC值为（0.74±0.12）×10-3s/mm2（95％可信区间为0.70×10-3～0.78×10-3s/mm2）,前列腺增生组的ADC值为（1.21±0.12）×10-3s/mm2（95％可信区间为1.18×10-3～1.24×10-3s/mm2）,差异有统计学意义（t=19.223,P＜0.01）.ADC值诊断前列腺癌的ROC曲线下面积为0.996,最佳诊断界值为0.946×10-3s/mm2,诊断前列腺癌的敏感度为95.3％（41/43）,特异度为98.4％（63/64）,准确度为97.2％（104/107）.结论 RESOLVE序列ADC值鉴别前列腺癌和良性前列腺增生具有一定价值.

英文摘要：

Objective To explore the value of readout segmentation of long variable echo-trains （RESOLVE） in the differentiation of prostate cancer from benign prostatic hyperplasia （BPH）.Methods Seventy two consecutive patients with suspected prostate cancer were evaluated by 3.0 T MR examination （RESOLVE sequence included,b values=0 and 800 s/mm2） were included in our retrospective study.All the patients had ultrasound guided systemic biopsy with histopathological diagnosis.The patients were divided into group A （23 prostate cancer cases with total 43 malignant lesions） and group B （49 BPH cases with total 64 benign lesions）.Two radiologists who were blinded to the clinical data quantitatively analyzed the ADC values of suspicious lesions independently.Inter-reader agreement for ADC values was assessed with Bland and Altman test,and the intra-class correlation coefficient （ICC）.Difference of ADC values in two groups was assessed by student＇s t test.Receiver operating characteristic curve （ROC） was used to determine the best predictor and cutoff value.Results A total of 107 lesions （43 malignant and 64 benign） were identified in 72 patients.ICC was 0.976,P〈0.01.The mean ADC value of prostate cancer is lower than BPH （t=19.223,P〈0.01）,（0.74±0.12） ×10 3 and （1.21±0.12） × 10-3mm2/s respectively.Diagnostic cut-off point was 0.946× 10-3mm2/s,diagnostic sensitivity 95.3 % （41/43）,specificity 98.4% （63/64）,accuracy 97.2% （104/107）.Conclusion RESOLVE ADC value is valuable in the differential diagnosis of prostate cancer and BPH.