磁共振弥散加权成像与动态增强在早期前列腺癌诊断中的应用分析  

Comparative study on magnetic resonance diffusion weighted imaging and dynamic contrast-enhanced scan in the diagnosis of early prostate cancer

作　　者：王省白[1] 高益萍 黎良山 李斌[1] 周冰[1] 陆黎明[1] 

机构地区：[1]浙江中医药大学附属嘉兴市中医院放射科,浙江嘉兴314001

出　　处：《医学影像学杂志》2015年第11期1991-1994,共4页Journal of Medical Imaging

基　　金：浙江省嘉兴市科技局资助项目编号:2012AY1072-5

摘　　要：目的探讨1.5T磁共振弥散加权成像与动态增强在早期前列腺癌诊断的不同作用。方法对我院经手术病理证实的前列腺癌49例,其中早期前列腺癌30例(外周带中早期18例,中央带中早期12例),前列腺增生53例,前列腺炎7例。扫描序列采用T1WI、T2WI、DWI,DWI扫描,测量DWI高信号区ADC值及观察ADC图;动态增强采用钆喷酸葡胺20ml静脉推注后扫描动脉期、静脉期及实质期三期,部分病例病灶区观察动态曲线。结果 27例外周腺体前列腺癌有1例误诊,而3例中央腺体前列腺增生误诊为前列腺癌,其中2例为b值选用800s/mm^2时,1例为b值选用1000s/mm^2时,而有4例前列腺增生误诊为前列腺癌,其中3例为b值选用800s/mm^2时,1例为b值选用1 000s/mm^2时。结论磁共振弥散加权成像结合动态增强在早期外周腺体前列腺癌准确率较高,而选用不同的b值其准确率各不相同,其中b值为1 200s/mm^2能提高中央腺体前列腺癌的诊断准确率,总体说来1.5T高b值弥散成像诊断准确率高于动态增强,而两种检查方法结合应用可提高早期前列腺癌的检出率。Objective To study the different role between 1.5T magnetic resonance diffusion weighted imaging and dynamic contrast-enhanced scan in the diagnosis of early prostate cancer.Methods MR imaging findings in 267 patients with prostate disease admitted to our hospital were analyzed retrospectively.There were forty-nine cases with pathology confirmed,including 30 cases of early prostatic cancer（18cases with the lesion in the peripheral prostate zone,and 12 cases in the central zone）,53 patients with benign prostatic hyperplasia,7cases of prostatitis.All the patients underwent T1 WI,T2WI and DWI scanning.We measured the ADC values of high signal area on DWI and observed the ADC figures.Meanwhile,each patient underwent dynamic contrast-enhanced with scanning arterial phase,venous phase and parenchymal phase after an intravenous injection of 20 ml Gd-DTPA.And,the signal intensity-time curve was observed.Results1 case of the 27 cases of prostate cancer occurred in peripheral zone was misdiagnosed.3cases of the prostate hyperplasia were occured in the central zone had been intitially misdiagnosed as benign prostatic cancer,including 2cases with b-values=800s/mm2,1case with b-values=1 000s/mm^2.In addition,4cases of benign prostatic hyperplasia had been misdiagnosed as prostate cancer,including 3cases with b-value=800s/mm^2,1case with b-value=1 000s/mm^2.Conclusion In this study,the combined approach of magnetic resonance diffusion weighted imaging and dynamic contrast-enhancement can improve the diagnostic accuracy of early peripheral zone of prostate cancer.The accuracy rate varies with different bvalues.When,the b-value=1 200s/mm^2,it can improve the diagnostic accuracy of central zone of prostate cancer.Generally,the diagnostic accuracy of 1.5 MRI high b-value DWI is higher than that of DCE-MRI,and the combination of the two approaches can improve the detection rate of early prostate cancer.

关 键 词：前列腺癌 磁共振成像 弥散加权成像 动态增强 

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