内分泌及调强放射治疗前、后前列腺癌MRI表现

MR evaluation of prostate cancer treated with endocrine therapy and intensity modulate radiation therapy

目的 评价前列腺癌内分泌及调强放射治疗前后磁共振表现。方法 分析 2 6例前列腺癌患者内分泌及调强放射治疗前后磁共振图像 ,观察治疗后前列腺及肿瘤体积、信号的变化。结果 治疗后前列腺体积平均缩小 ( 3 4.3±18.2 ) % (P <0 .0 1) ,周围带体积缩小程度 [( 5 6.1± 2 1.6) % ]大于移行带缩小程度 [( 3 0 .5± 2 1.1) % ] (P <0 .0 5 ) ;T2加权像上前列腺周围带及移行带信号显示不同程度的弥漫性减低 ;前列腺体积缩小与血清前列腺特异抗原 (PSA)水平下降之间有显著性相关 (r =0 .67,P <0 .0 5 )。结论 前列腺癌内分泌及调强放射治疗后磁共振表现为前列腺、肿瘤、精囊体积缩小、信号减低。

ObjectiveTo evaluate the effect of hormonal therapy and intensity modulate radiation therapy (IMRT) on patients with prostate cancer using MRI. MethodsMRI findings of 26 patients with prostate cancer before and after hormonal treatment and IMRT were studied. MR imaging included axial plane T1 weighted images (TR/TE, 500/15), axial/coronal plane fast spin echo T2 weighted images (TR/TE, 4 000/102 ms) and axial fast dynamic contrast enhanced images with surface coil. Imaging evaluation was obtained by consensus, including assessment of the gland size, signal intensity, tumor depiction, extracapsular extension and seminal vesicles invasion. ResultsAfter hormonal therapy and IMRT, the volume of the prostate gland showed a mean decrease of (34.3±18.2)% ( P <0.01). Volume reduction in the transition zone [mean, ( 30.5 ±21.1)%] was less than in the peripheral zone [mean, (56.1±21.6)%] ( P <0.05). On T2WI, homogeneous decreases in signal intensity of the peripheral zone was found in all patients. There was positive correlation between changes in the prostate volume and prostate specific antigen levels after hormonal therapy and IMRT ( P <0.05, r =0.67). ConclusionHormonal therapy and IMRT may decrease the size and signal intensity of the prostate gland and tumor, as well as seminal vesicles. They can also alleviate the capsular invasion of the tumor.