前列腺癌内分泌治疗疗效的MRI评价  

Effects of endocrine therapy on the primary lesions in patients with prostate cancer as evaluated by magnetic resonance imaging

作　　者：王霄英[1] 蒋学祥[1] 肖江喜[1] 王纪琛 高玉洁[1] 

机构地区：[1]北京医科大学第一医院医学影像科,100034

出　　处：《中华放射学杂志》2000年第6期402-404,共3页Chinese Journal of Radiology

摘　　要：目的　用MRI定量评价前列腺癌内分泌疗法的治疗效果。方法　 2 0例经病理证实的前列腺癌患者用内分泌疗法平均治疗 110d ,对治疗前后的MRI表现进行比较。结果　内分泌疗法治疗约 110d后 ,前列腺、肿瘤部分和非肿瘤部分体积分别减少了 5 1 5 6 % (t=19 34 ,P <0 0 5 )、80 87%(t=9 76 ,P <0 0 5 )和 48 94% (t=17 78,P <0 0 5 ) ,提示肿瘤部分较非肿瘤部分对内分泌治疗更敏感。T2 WI显示 8例患者外周带弥漫性信号减低 ,不易区分外周带的肿瘤和非肿瘤组织。双侧精囊腺体积缩小了 33 33% (t=6 0 9,P <0 0 5 )。 14例患者显示双侧精囊腺对称性信号减低。结论　MRI是评价前列腺癌内分泌疗法效果的一种很好的影像学方法。内分泌治疗后前列腺和前列腺癌体积缩小 ,前列腺癌组织比非肿瘤组织对内分泌治疗更敏感。但对于内分泌治疗后外周带正常T2 WI高信号明显减低的患者 ,MRI对前列腺癌的检出和确定其大小有一定困难。Objective To investigate the quantitative effects of endocrine therapy on the primary prostate cancer using MRI Methods The primary cancer was evaluated by MRI approximately 110 days after the initiation of endocrine therapy in 20 patients with histologically confirmed prostate carcinoma detected by MRI before therapy Results The volumes of the prostate gland, the carcinoma, and the noncarcinomatous components were reduced 51 56%, 80 87% and 48 94% of their pretreatment volumes respectively after endocrine therapy, indicating that the tumors were more susceptible to endocrine therapy than the nontumourous components On T 2WI the peripheral zone showed homogeneous decreases in signal intensity in 8 of 20 patients, making it difficult to differentiate the tumorous and nontumorous portion The seminal vesicles showed decreased volume bilaterally, and 14 of the 20 patients yielded symmetrical low signal intensities Conclusion MRI is the method of choice in the follow up of the endocrine therapy of the primary prostate cancer This study suggests that downsizing of the prostate cancer may occur after endocrine therapy In addition, the tissue of the prostate cancer might be more sensitive to the endocrine therapy than the residual noncancerous prostate gland However, when the normal high signal intensities of the peripheral zone decrease significantly in the T 2 weighted images, we could hardly differentiate the normal tissue from the prostate cancers after endocrine therapy

关 键 词：前列腺肿瘤 磁共振成像 内分泌治疗 疗效 评价 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.250.4[医药卫生—诊断学]