前列腺癌局部侵犯的MRI评价  

The assessment of MRI for local extension of prostatic cancer

作　　者：潘颂华[1] 孙兮文[1] 叶春涛[1] 郑晓春[2] 嵇鸣[1] 陈素珍[1] 

机构地区：[1]上海华东医院放射科MR室,200040 [2]上海华东医院泌尿外科,200040

出　　处：《上海医学影像》2003年第3期183-185,共3页Shanghai Medical Imaging

摘　　要：目的 探索前列腺癌(prostatic cancer,PC)腺外局部侵犯(C期)的MR影像诊断价值。 方法 1.回顾性总结近年来经病理、临床资料证实的20例C期(T3NOMO)PC病例,分析腺周侵犯病灶的影像特点。2.病理结果:腺外灶均为转移性腺癌。设备1.5Tesla(西门子Vision)。快速自旋回波(TSE)序列,11例平扫后增强(Gd-DTPA 0.1mmol/kg)。 结果 1.主要侵犯部位:精囊腺30％(6/20);膀胱30％(6/20);腺旁组织25％(5/20);直肠周围15％(3/20)。2.形态大小:结节型(≤1.0cm)均单发占25％(5/20);肿块型65％(13/20);浸润型10％(2/20)。3.信号强度:T1W等信号、T2W高信号占65％(13/20),急性出血T1W高信号35％(7/20)。4.包膜累及或破坏占75％(15/20)。5.其他:积液15％(3/20);血管破坏15％(3/20)。6.增强扫描:不均匀强化占72.7％(8/11)。 MRI诊断率:检出率95％(19/20)、定位正确率95％(19/20)、定性正确率80％(16/20)。 结论 MRI在检查发现和明确诊断PC腺外局部侵犯(C期)方面具有重要价值。Purpose To explore the diagnostic value of local extension of prostatic cancer by MRI. Methods 20 cases of pro-static cancer extended to the periprostate underwent MRI examination with 1.5 tesla,tubo spin echo(TSE)sequiences. The findings of MRI were analyzed retrospectively and compared with pathology results and clinic data. Among the cases, 11 cases of them had experienced the contrast scanning (Gd-DTPA 0.1mmol/kg) after plain scanning. Results 1.Invided location: seminal 30%(6 / 20); urinary bladder 30% (6 / 20); periprostate tissue 25%(5 / 20); perirectal spaces 15%(3 / 20). 2.Pattern and size: single nodule (≤1.0cm) 25%(5 / 20); mass 65% (13 / 20); infiltrations10%(2 / 20). 3.Sign intensity: T2WI high signal 75%(5 / 20); T1WI middle signal 65%(13 / 20),acute bleed high signal 35%(7/20). 4. Contrast enhance (Gd-DTPA O.lmmol/kg): heterogeneous enhancement 72.7%(8 / 11). 5. Cupsute invasion: pushing or pressure 75%(15 / 20). 6. The others;infiltration fluid 15%(3 / 20); Blood vessel invasion 15%(3 / 20). The diagnosising rate of MRI for the periprostate infiltration included; the detection rate 95%(19 / 20), localization rate 95%(19 / 20) and quality rate 80%(16/ 20). Conclusion MRI may be the important method of demonstrating of local invasion by prostatic cancer.

关 键 词：局部 前列腺癌 MRI 诊断 侵犯 病理 影像特点 回顾性 肿块型 转移性 

分 类 号：R737.25[医药卫生—肿瘤] R735[医药卫生—临床医学]