CT在前列腺癌诊断及分期中的价值  

The value of CT diagnosis and staging of prostate cancer

作　　者：苑任[1] 史河水[1] 韩萍[1] 戴文[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,湖北省430022

出　　处：《放射学实践》2002年第1期40-43,共4页Radiologic Practice

摘　　要：目的 :探讨CT用于前列腺诊断及分期的价值。方法 :回顾分析 40例前列腺癌 (2 4例经病理或细胞学证实 ,1 6例经临床证实 )的CT征象 ,进行CT分期 ,1 2例行MPR重建。参照J W标准对比CT分期与临床分期。结果 :40例前列腺癌 ,CT表现前列腺正常 2例 ,增大 38例 ;前列腺内局限性病灶 1 7例 ,病灶结节状、肿块状外突 2 3例 ;病灶平扫低 /低混密度 2 7例 (67.5 % ) / 3例 (7.5 % ) ,平扫等密度、增强后为低密度 1 0例 (2 5 % ) ;钙化 1 3例。侵及精囊腺、膀胱、直肠、盆腔淋巴结及远处转移各 1 1例、1 9例、9例、5例、6例 ;CT复合征象 2 3例 (57.5 % )。CT分期的总准确率为 82 .5 % ,C、D期符合率为90 %和 66 .7% ,区分A/B期和C/D期的敏感性 90 %。结论 :CT复合征象对前列腺癌的诊断有较高的特异性 ,结合 3D MPR有助于定位诊断。CT能较准确的区分A/B期和C/D期肿瘤 ,对C。Objective:To evaluate CT in the diagnosis and staging of prostate cancer.Methods:40 cases of prostate cancer,of which 24 cases were confirmed by pathology and biopsy and 16 by clinical data,were performed CT scanning.12 of 40 cases were processed with 3D MPR.A comparative study of CT staging and clinical staging referred to JW criteria was subsequently made. Results:In 40 cases of prostate cancer,their CT appearances were as following:the prostate was normal in size in 2 cases and enlarged in 38 cases;the lesion was limited in the prostate in 17 cases and extended over the prostate in 23;the density of mass was lower than the normal prostate in 27 cases(67.5%) and there was mixed density with equal to and lower than normal in 3 cases (7.5%).The density of mass in 10 cases (25%) appeared equal to normal on non enhanced CT but turned lower on enhanced.Patchy calcification was seen in 13 cases. Involvement of seminal vesicle,bladder and rectum,pelvic lymph nodes enlargement and distant metastasis were shown in 11,19,9,5,6 cases respectively.The comprehensive CT signs were demonstrated in 23 cases (57.5%).The accuracy of CT staging in stage C,D and overall accuracy was 90%, 66.7% and 82.5%,respectively.The sensitivity of CT was 90% for distinction between stage A/B and C/D.Conclusion:The comprehensive CT signs may be specific in diagnosing prostate cancer which together with 3D MPR are helpful to locate tumor. CT can accurately distinguish prostate cancer with the stage A/B from C/D,and make an accurate diagnosis of prostate cancer with the stage C/D.

关 键 词：前列腺癌 CT 诊断 肿瘤分期 

分 类 号：R737.25[医药卫生—肿瘤] R730.44[医药卫生—临床医学]