Objective To explore the advantage of advanced diffusion weighted imaging(DWI)over single index DWI in distin-guishing low-grade transitional zone prostate cancer(TZ-PCa)from benign prostatic hyperplasia(BPH)with inflammation.Methods Thirty-two patients with low-grade TZ-PCa(low-grade TZ-PCa group)and 38 patients with BPH with inflammation(BPH with inflammation group)confirmed by pathology were selected.All patients underwent routine MR sequence,single index DWI,and advanced DWI[including introvoxel incoherent motion diffusion weighted imaging(IVIM-DWI),stretched-exponential model(SEM),diffu-sion kurtosis imaging(DKI)]sequences scans.The related parameters of the lesion area[including apparent diffusion coefficient(ADC),diffusion coefficient(D),distributed diffusion coefficient(DDC),and mean kurtosis(MK)values]were measured.Independ-ent sample t-tests were used to compare differences in parameters values between the two groups.The receiver operating characteris-tic(ROC)curve was used to calculate the area under the curve(AUC)of varous parameters values in the differential diagnosis of low-grade TZ-PCa and BPH with inflammation.The difference in AUC between advanced DWI and single index DWI was compared using Z-test.Results The ADC,D,and DDC values of the low-grade TZ-PCa group were lower than those of the BPH with inflammation group(P<0.05).The MK value of the low-grade TZ-PCa group was higher than that of the BPH with inflammation group(P<0.05).The D,DDC,and MK values,and a combination of these parameters(D+DDC+MK)exhibited high diagnostic effi-cacy(all AUC>0.9).The diagnostic efficacy of these parameters was significantly higher than that of the ADC value(AUC 0.902,0.904,0.966,0.994 vs 0.725,all P<0.05).The combined param-eter demonstrated the highest AUC.Although the diagnostic efficacy of the combined parameter was not statistically different from the individual D,DDC,and MK values(P>0.05),the diagnostic specificity was significantly improved compared to the individual parame-ters.Conclusion Advanced DWI(IVIM-DWI,SEM,DKI)has a higher diagnostic efficacy in distinguishing low-grade TZ-PCa from BPH with inflammation than single index DWI.Combining the parameters(D+DDC+MK)further improves diagnostic specificity.

Objective To explore the advantage of advanced diffusion weighted imaging(DWI)over single index DWI in distin-guishing low-grade transitional zone prostate cancer(TZ-PCa)from benign prostatic hyperplasia(BPH)with inflammation.Methods Thirty-two patients with low-grade TZ-PCa(low-grade TZ-PCa group)and 38 patients with BPH with inflammation(BPH with inflammation group)confirmed by pathology were selected.All patients underwent routine MR sequence,single index DWI,and advanced DWI[including introvoxel incoherent motion diffusion weighted imaging(IVIM-DWI),stretched-exponential model(SEM),diffu-sion kurtosis imaging(DKI)]sequences scans.The related parameters of the lesion area[including apparent diffusion coefficient(ADC),diffusion coefficient(D),distributed diffusion coefficient(DDC),and mean kurtosis(MK)values]were measured.Independ-ent sample t-tests were used to compare differences in parameters values between the two groups.The receiver operating characteris-tic(ROC)curve was used to calculate the area under the curve(AUC)of varous parameters values in the differential diagnosis of low-grade TZ-PCa and BPH with inflammation.The difference in AUC between advanced DWI and single index DWI was compared using Z-test.Results The ADC,D,and DDC values of the low-grade TZ-PCa group were lower than those of the BPH with inflammation group(P<0.05).The MK value of the low-grade TZ-PCa group was higher than that of the BPH with inflammation group(P<0.05).The D,DDC,and MK values,and a combination of these parameters(D+DDC+MK)exhibited high diagnostic effi-cacy(all AUC>0.9).The diagnostic efficacy of these parameters was significantly higher than that of the ADC value(AUC 0.902,0.904,0.966,0.994 vs 0.725,all P<0.05).The combined param-eter demonstrated the highest AUC.Although the diagnostic efficacy of the combined parameter was not statistically different from the individual D,DDC,and MK values(P>0.05),the diagnostic specificity was significantly improved compared to the individual parame-ters.Conclusion Advanced DWI(IVIM-DWI,SEM,DKI)has a higher diagnostic efficacy in distinguishing low-grade TZ-PCa from BPH with inflammation than single index DWI.Combining the parameters(D+DDC+MK)further improves diagnostic specificity.

Objective To discuss the MRI features of pyometra and its correlation with pathologic.Methods MRI and DWI data of 12 cases pyometra proved by surgery and pathology were analyzed retrospectively, and a comparision with pathologic findings was made.Mean ADC values were calculated.Results According to the homogeneity of MRI signal: Uniform signal type in 2 cases,T1WI showed slightly low signal,T2WI showed slightly high signal,DWI showed high signal,and the distribution of pus compositions is relatively uniform;Signal mixed type in 5 cases, T2 showed at the bottom of the pus or peripheral mixed slightly short signal, DWI showed mixed high signal, there was some sediment in the bottom of the pus;5 cases of liquid layer type, the upper displayed signal of water,and the lower signal was lower than the upper signal on T2WI, of which 3 cases showed uniform signal of the lower, DWI showed a uniform high signal, the distribution of pus compositions is uniform, the other 2 cases showed mixed signal of the lower, which was pyometra with bleeding,DWI showed high signal and low signal mixed together.The average ADC value of the 12 patients were 0.532×10-3 mm2/s.12 cases of uterine volume were increased, including 10 cases of uterine wall thinning, the other 2 cases with inflammatory invasion, the uterine wall thickening.8 cases with cervical cancer.5 cases with pelvic effusion.Conclusion MRI findings of pyometra are characteristic, its MRI manifestations and pathological components are highly correlated,and the ADC value is of great value in the diagnosis of pyometra.