MR扩散、灌注成像鉴别前列腺良恶性病变的价值  

Study of MR Diffusion-weighted Imaging and Perfusion-weighted Imaging in the Differential Diagnosis of Prostate Lesions

作　　者：张继斌[1] 沈钧康[1] 许建铭[1] 须同禄[1] 陆之安[1] 

机构地区：[1](南京医科大学附属)苏州市立医院本部放射科,江苏215002

出　　处：《临床放射学杂志》2008年第3期354-359,共6页Journal of Clinical Radiology

摘　　要：目的探讨MR扩散成像(DWI)和灌注成像(PWI)在鉴别前列腺良恶性病变诊断中的应用价值。资料与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例分别进行MR弥散成像和灌注成像,测算病灶的表观扩散系数(ADCs);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(ΔR2*peak)与免疫组织化学结果(VEGF、MVD)的各自相关性。结果(1)BPH组前列腺中央带增生结节、外周带的平均ADC值分别为:(1.783±0.282)×10-3mm2/s,(2.025±0.358)×10-3mm2/s;PCa组前列腺中央带、外周带癌灶平均ADC值分别为:(1.632±0.082)×10-3mm2/s,(0.267±0.07)×10-3mm2/s。PCa组外周带癌灶平均ADC值明显低于BPH组增生结节(P<0.05);(2)BPH组增生结节灌注曲线的SSmax及ΔR2*peak分别为:33.5±3.1、1.5±0.1;PCa组癌灶灌注曲线的SSmax及ΔR2*peak分别为:58.4±4.7,3.14±0.5,两者之间差异有统计学意义(P<0.05);(3)BPH组VEGF阳性、阴性例数分别为9例和33例,MVD平均值为22.76±6.54;PCa组VEGF阳性、阴性例数分别为24例和4例,MVD平均值为71.38±9.17;PCa的VEGF和MVD的表达水平明显高于BPH(P<0.01),PCa、BPH的VEGF表达与MVD表达呈正相关性(P<0.01);灌注成像(PWI)参数SSmax、ΔR2*peak与VEGF、MVD具有相关性(P<0.01)。结论DWI可对BPH与PCa的ADC值进行定量分析,PWI可反映前列腺良恶性疾病的血管生成情况,有助于鉴别前列腺良恶性病变。Objective To investigate the use of MR diffusion-weighted imaging （DWI） and perfusion-weighted imaging （PWI） in the differential diagnosis of prostate lesions. Methods DWI and PWI performed in 70 patients including 42 patients with benign prostate hyperplasia （BH） and 28 cases with prostate cancer （PCa） confirmed by pathology were used to measure the apparent diffusion coefficient （ ADC ） values, the slope of signal intensity-time curve （SSmax） and the peak △R2^ ＊ （△R2 ^＊ peak） in anatomical regions of the prostate. We studied correlation between the results of DWI and PWI and immuno-histochemical findings including microvessel density （MVD） and levels of vascular endothelial growth factor （VEGF） expression. Results The average ADC values in the central zone and peripheral zone were （1. 783× 0. 282）×10^-3mm^2/sand （2. 025 ± 0. 358） ×10^-3mm^2/s, respectively in BH group, and （1.632 ±0.082）×10^-3mm^2/s and （0. 267±0.07） ×10^-3mm^2/s, respectively in PCa group. The average ADC values of the peripheral zone in PCa group were significantly lower than those in BH group （ P 〈 0.05 ）. SSmax and △R2^ ＊ peak were 33.5 ± 3.1 and 1.5 ± 0.1 respectively in BH, and 58.4 ± 4.7, 3.14 ± 0.5, respectively in PCa. There was significant difference in SSmax and △R2 ^＊ peak between the two groups （ P 〈 0.05 ）. In BH group, positive VEGF expression was observed in 9 cases and negative VEGF expression in 33 cases, and average MVD was 22.76 ± 6.54. In PCa group, positive VEGF expression was observed in 24 cases and negative VEGF expression in g cases, and average MVD was 71.38 ±9.17. The levels of VEGF expression and MVD in PCa group were significantly higher than those in BH group （P 〈 0.01 ）. MVD was shown to positively correlate with levels of VEGF expression in the two groups （ P 〈 0.01 ）. SSmax and △R2 ^＊ peak correlated with MVD and levels of VEGF expression （ P 〈 0.01 ）. Conclusions DWI could enable quantification o

关 键 词：前列腺 增生 肿瘤 磁共振成像 扩散 灌注 

分 类 号：R445.2[医药卫生—影像医学与核医学]