前列腺癌内分泌治疗后体素内不均一运动扩散加权成像的初步研究  

lntravoxel incoherent motion diffusion-weighted imaging of prostate cancer after endocrine therapy：preliminary study

作　　者：蔡文超[1] 李玮[1] 李飞字[1] 叶锦棠[1] 魏娟 Queenie Chan 王岳[1] 王霄英[1] 蒋学祥[1] 

机构地区：[1]北京大学第一医院医学影像科,北京100034 [2]飞利浦医疗保健事业部

出　　处：《实用放射学杂志》2012年第12期1823-1826,共4页Journal of Practical Radiology

摘　　要：目的 应用多b值DWI序列评估前列腺癌内分泌治疗后扩散与灌注信息的改变情况。方法 10例前列腺癌内分泌治疗后患者及12倒前列腺癌患者被纳入研究。所有患者均经超声引导下前列腺穿刺活检病理证实为前列腺癌，且在3．0TMR扫描进行了多b值DWI序列（b值分别为0，188，375，563，750s／mm^2）扫描。应用双指数模型（体素内小均一运动法）分析，计算并比较内分泌治疗组和未治疗组的癌区及非癌区的相对纯扩散似D，灌注分数f的变化。结果 内分泌治疗后癌区D值与f值分别为（1．16±0．08）×10^-3mm^2／s和（0．2±0．1）％。未治疗组癌区D值与f值分别为（0．76±0．05）×10^-3mm^2／s和（16．1±5．2）％。内分泌治疗后癌区的D值和f值与未治疗组癌区的D值和f值比较，差异均有显著统计学意义（P〈0．01）。结论 内分泌治疗后癌区D值升高，f值下降。多b值DWI序列可用于评价前列腺癌内分泌治疗后D和f的变化，为无创评估前列腺癌内分泌治疗的疗效提供了可能。Objective To assess the diffusion and perfusion changes of proslate cancer （PCa） and noncancerous area after endocrine therapy using nndti b value DWh Methods Ten patients with PCa after endocrine therapy and 12 patients with PCa without any treatment were recruited in the study. All of them undergone the multi-b value DWl （b=0, 188, 375, 563, 750 s/mm^2） examination ona 3.0 T MR scanner. Quantitative analysis was conducted usingaintravoxelincoherent minion （IVIM） bi exponential rood el. Then the pure diffusion coefficient （D） and perfusion fraction （f） in the cancerous and noncancerous areas were calculated andcompared（ independent t test）between the two groups. Results The D and f values in cancer loci were （1. 16±0.08）×10^-3m^2/s and （0.2±0. 1）% in the endocrine treatment group. Whereas theDand fvalues in cancer loci were （0.76±0.05）×10^-3m^2/s and （16. 1±5.2） % in non treatment group. The difference of D and f in the two groups were both statistically different （both P〈 0.01）. Conclusion The IVIM muhi b value DWI can extract the diffusion and perfusion changes of prostate cancer after endocrine therapy, and maybe a promising technique in detecting the recurrence lesion after therapy.

关 键 词：前列腺癌 内分泌治疗 磁共振成像 扩散加权成像 体素内不均一运动 

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