MR灌注成像在前列腺疾病诊断中作用的初步探讨  

Preliminary application of MR perfusion-weighted imaging in the benign and malignant prostate diseases

作　　者：张继斌[1] 沈钧康[2] 许建铭[1] 须同禄[1] 李晓兵[1] 刘仁坚[1] 汤建英[1] 陆之安[2] 

机构地区：[1]南京医科大学附属苏州医院放射科,215002 [2]苏州大学附属第二医院MRI室

出　　处：《中华放射学杂志》2006年第7期699-703,共5页Chinese Journal of Radiology

摘　　要：目的探讨MR灌注成像在前列腺良恶性病变中的初步应用,评价血管内皮生长因子(VEGF)和微血管密度(MVD)与MR灌注成像各指标的关系。方法对临床诊断为前列腺疾病的70例患者,其中良性前列腺增生(BPH)42例,前列腺癌(PCa)28例,进行MR灌注成像,并对标本进行免疫组织化学检测;分析病变的灌注曲线最大线性斜率(SSmax)、T2*弛豫率(△R2* peak)与免疫组织化学检查结果(VEGF、MVD)的相关性。结果(1)BPH组增生结节灌注曲线的SSmax及△R2*peak分别为:33．5±3．1、1．5±0．1;PCa组癌灶灌注曲线的SSmax及△R2*peak分别为:58．4±4．7、3．1±0．5,两者之间差异有统计学意义(t值分别为2．13、2．29,P值均<0．05);PCa组高、中、低分化腺癌的SSmax分别为:52．3±3．4、56．4±4．3、60．7±5．2,差异有统计学意义(F=132．04,P< 0．05),△R2*peak分别为:2．9±0．4、3．1±0．5、3．2±0．7,差异有统计学意义(F=114．82,P<0．05)。(2)BPH组VEGF阳性9例,MVD值为22．76±6．54;PCa组VEGF阳性为24例,MVD值为71．38±9．17;PCa的VEGF和MVD的表达水平明显高于BPH患者(X2=27．86,P<0．01;t=20．4,P< 0．01),PCa、BPH的VEGF表达与MVD表达呈正相关性(P<0．01);灌注加权成像(PWI)参数SSmax、△R2*peak与VEGF、MVD具有相关性(P<0．01)。结论PWI的有关指标(SSmax、△R2*peak)与MVD和VEGF的表达水平相关,有可能为前列腺疾病良恶性的鉴别提供信息。Objective To explore the preliminary application of perfusion-weighted MR imaging in the benign and malignant prostate diseases, and evaluate the correlation of PWI features with vascular endothelial growth factor （VEGF） and microvessel density （MVD）. Methods Seventy consecutive patients who were diagnosed clinically for the prostatic diseases, including forty-two cases with benign prostate hyperplasia and twenty-eight cases with prostate cancer proved pathologically, were examined by PWI. MVD and VEGF were stained with immuno-histochemical methods. Some parameters of PWI, including the steepest slope of signal intensity-time curve （SSmax） and △R2^＊ peak at lesions, were put more analyses. Correlation analysis was used to determine the relation between the results of PWI and that of immunohistochemistry. Results （ 1 ） In the benign prostate hyperplasia, SSmax and △R2^＊ peak of perfusion curve were 33.5 ±3. 1 and 1.5 ± 0. 1 respectively. However, in the prostate cancer the SSmax and △R2^＊ peak were 58.4 ±4. 7 and 3. 1 ±0. 5 respectively. There were statistically significant difference（ t = 2. 13, 2. 29, P 〈 0.05 ） between them. SSmax of perfusion curve in the prostate cancer （high differentiation, middle differentiation, low differentiation ） was 52. 3 ± 3. 4, 56. 4 ± 4. 3, 60. 7 ± 5.2 respectively, it had statistical differences in three groups（F= 132.04,P 〈0.05）. △R2^＊ peak of perfusion curve was 2.9 ±0.4, 3. 1 ± 0. 5, 3.2 ± 0. 7 respectively, it also had statistical differences in three groups （ F = 114. 82,P 〈 0. 05 ）. （2） In the benign prostate hyperplasia, positive and negative VEGF expression was 9 cases and 33 cases respectively, MVD average value was 22. 76 ±6. 54. In the prostate cancer, positive and negative VEGF expression was 24 cases and 4 cases respectively, MVD average value was 71.38±9. 17. The VEGF and MVD expression of 28 PCa patients were significantly higher than those of 42 BPH patients（x^2 = 27.86, P 〈0. 01; t =20. 4,

关 键 词：前列腺增生 前列腺肿瘤 磁共振成像 灌注 

分 类 号：R445.2[医药卫生—影像医学与核医学]