Abstract: Objective The surgical approaches for prostate cancer （PCa） and benign prostatic hyperplasia （BPH） differ. PCa typically requires radical prostatectomy, while BPH is often managed with partial resection to alleviate symptoms. This study aimed to utilize quantitative dynamic contrast-enhanced magnetic resonance imaging （qDCE-MRI） to differentiate between PCa and BPH, thereby guiding the selection of surgical strategy. Methods Fifty-four patients with prostate nodules underwent conventional MRI and qDCE-MRI. The qDCE-MRI data were analyzed using the extended Tofts model to calculate quantitative and semi-quantitative parameters. The Mann-Whitney U test was employed to compare the differences in qDCE-MRI parameters between PCa and BPH groups. The predictive efficacy of each parameter was evaluated using receiver operating characteristic （ROC） curve analysis. The Spearman rank correlation test was used to analyze the linear correlation between quantitative parameters and PCa ISUP grade groups. Results Among the 54 patients, there were 31 cases of PCa and 23 cases of BPH. The PSA, Ktrans, Kep, Cmax, and Slopemax values were significantly higher in the PCa group than in the BPH group, while TTP was lower in the PCa group （P<0.05）. The areas under the ROC curve for differentiating PCa from BPH ranged from 0.710 to 0.971. The sensitivity, specificity, and accuracy of PI-RADS score in discriminating PCa from BPH were 0.784, 0.882 and 0.815, respectively. Slopemax showed a positive correlation with the PCa ISUP grade group （r=0.451, P=0.011）, whereas other parameters did not exhibit significant correlations （P>0.05）. Conclusion Both semi-quantitative and quantitative parameters derived from qDCE-MRI can effectively distinguish PCa from BPH, providing valuable guidance for selecting the appropriate surgical approach for prostate diseases.

Key words: prostatecancer, benignprostatichyperplasia, magneticresonanceimaging, dynamiccontrast-enhanced

摘要： 目的 前列腺癌（PCa）和良性前列腺增生（BPH）手术方式不同。PCa采用前列腺全切术,而BPH多选择局部切除以缓解症状。本研究旨在利用定量动态增强磁共振检查（qDCE-MRI）鉴别PCa和BPH,从而指导术式选择。方法 对54例前列腺结节的患者行常规磁共振和qDCE-MRI。qDCE-MRI数据采用Tofts扩展模型计算定量和半定量参数。采用Mann-Whitney U秩和检验比较qDCE-MRI参数在PCa和BPH之间的差别。采用受试者工作特征（ROC）曲线分析各参数的预测效能。采用Spearman秩相关性检验分析定量参数与PCa ISUP分组的线性相关性。结果 54例患者中,PCa 31例,BPH 23例。PCa组的PSA、Ktrans、Kep、Cmax和Slopemax均显著高于BPH组,而PCa组的TTP则低于BPH组（P<0.05）。各参数鉴别PCa和BPH的ROC曲线下面积为0.710~0.971。PI-RADS评分鉴别PCa和BPH的敏感度、特异度和准确度分别为0.784、0.882和0.815。Slopemax与PCa ISUP分组呈正相关（r=0.451,P=0.011）,其余参数与PCa分组不具有相关性（P>0.05）。结论 qDCE-MRI半定量参数和定量参数可有效鉴别PCa和BPH,从而为前列腺疾病选择合适的术式提供有价值的指导。

关键词: 前列腺癌, 前列腺增生, 磁共振成像, 动态增强