磁共振DWI及动态增强对前列腺癌的诊断  

Value of diffusion-weighted imaging and dynamic contrast enhancement in the diagnosis of prostate carcinoma

作　　者：李君[1] 金彪[1] 张海兵[1] 曾凡勇[1] 黄汉琴[1] 

机构地区：[1]上海市崇明县上海交通大学附属新华医院崇明分院放射科,上海202150

出　　处：《现代泌尿外科杂志》2012年第5期473-476,共4页Journal of Modern Urology

摘　　要：目的探讨磁共振弥散加权成像及动态增强在前列腺癌诊断中的价值。方法分别对24例前列腺癌(PCa)患者、30例前列腺增生(BPH)患者行前列腺DWI及动态增强扫描,15名健康志愿者进行前列腺DWI扫描。分析3组DWI图、ADC图的信号表现,测量ADC值,比较PCa组及BPH组动态增强曲线。所有PCa病例、BPH病例均经手术或穿刺活检病理证实。结果 DWI上PCa表现为高信号影,BPH呈混杂信号,志愿者外周带呈稍高信号。PCa癌灶平均ADC值0.98×10-3 mm2/s,增生结节平均ADC值1.46×10-3 mm2/s,志愿者前列腺外周带平均ADC值1.85×10-3 mm2/s,三者之间的差异互有统计学意义(P<0.05)。动态增强PCa主要表现为早期强化,BPH主要表现为逐渐强化,PCa与BPH的时间-信号强度曲线类型差异有统计学意义(P<0.05)。结论在DWI图像上,PCa癌灶信号较高。PCa癌灶的ADC值低于正常前列腺外周带及前列腺增生。动态增强时PCa癌灶以早期强化为主。这二者均可作为前列腺癌的诊断依据。Objective To explore the value of diffusion-weighted imaging （DWI） and dynamic contrast enhancement in the diagnosis of prostate carcinoma （PCa）, Methods 24 patients with Pca and 30 patients with benign prostatic hyperplasia （BPH） were scanned with DWl and dynamic contrast enhanced sequences,and 15 healthy volunteers were scanned with DWI. All PCa and BPH cases were confirmed with surgery or needle biopsy. DWI image,apparent diffusion coefficient （ADC） map and ADC values of the three groups were analyzed. The dynamic enhancement curves of the PCa group and BPH group was compared. Results PCa showed very high signal on DWI images,BPH showed mixed signal,while the peripheral zone of volunteers showed slightly higher signal. The mean ADC values of PCa, nodules of BPH and peripheral zone of volunteers were 0.98 × 10-3 mm2/s, 1.46× 10-3 mmz/s and 1.85 × 10-3 mmz/s, respectively, with significant differences among the three groups （P〈0.05）. Most PCa cases enhanced obviously in the early stage,while most BPH cases enhanced gradually. Time-signal intensity curve type between PCa and BPH group was significantly different （P〈0.05）. Conclusions PCa shows very high signal on DWI images. ADC value of PCa is lower than that of BPH or normal peripheral zone. PCa shows early enhancement in dynamic contrast-enhanced scan. Both DWI and dynamic contrast enhancement can serve the diagnosis of prostate carcinoma.

关 键 词：前列腺肿瘤 扩散加权成像 动态增强 诊断 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学]