MR扩散加权成像在评价前列腺癌内分泌治疗中的应用价值

MR diffusion weighted imaging of the prostate adenocarcinoma after endocrinotherapy:preliminary results

目的探讨内分泌治疗前后前列腺外周带癌区和非癌区的表观扩散系数(ADC)值的变化情况。方法对经手术病理或穿刺活检证实的14例前列腺癌和18例内分泌治疗6个月以上的前列腺癌患者行 MR 扩散加权成像(DWI)。依病理结果,将前列腺6分区归类为癌区和非癌区,测量每个分区的 ADC 值,同时测量每例膀胱、闭孔内肌的 ADC 值,对2组的结果进行比较。结果未治疗组14例癌区和非癌区的 ADC 值分别为(1.22±0.25)×10^(-3)、(1.59±0.19)×10^(-3)mm^2/s,差异有统计学意义(t=7.03,P<0.01)。经内分泌治疗后的18例癌区的 ADC 值升高至(1.46±0.30)×10^(-3)mm^2/s,非癌区的 ADC 值为(1.59±0.24)×10^(-3)mm^2/s,癌区和非癌区之间 ADC 值差异有统计学意义(t=2.46,P<0.05)。两组癌区之间 ADC 值差异有统计学意义(t=4.66,P<0.01),非癌区、膀胱、闭孔内肌的 ADC 值差异无统计学意义(t 值分别为0.06、0.48、1.64,P 值均>0.05)。结论 ADC 值用于判断前列腺癌内分泌治疗效果有应用前景。

Objective To assess the changes of the apparent diffusion coefficient （ADC） values of cancerous and noncancerous regions of prostate peripheral zone in prostate cancer patients with and without endocrinotherapy. Methods Diffusion-weighted echo-planar imaging （EPI） were performed in 32 patients with diagnosed prostate cancer, including 18 patients who were treated with endocrinotherapy over 6 months and 14 untreated matched control patients. According to the pathological results obtained by ultrasound guided biopsy, the locations of the prostate cancerous regions were marked at one or more of the sextants. The ADC values of the bladder and the obturator internus were also measured. Results The mean ADC values of cancerous and noncancerous regions in 14 untreated controls were （ 1.22 ± 0. 25 ）×10^-3, （1.59 ±0. 19）×10^-3 mm^2/s, respectively （ t = 7. 03, P 〈 0. 01 ） . For 18 endocrine treated prostate patients, the ADC values remained （1.59 ±0. 24）×10^-3 mm^2/s in noncancerous regions, but increased to （1.46 ±0. 30）×10^-3 mm^2/s in cancerous regions. There still had significant difference between the cancerous and the noncancerous regions （ t = 2.46, P 〈 0. 05 ）. There was statistically difference of mean ADC values in the cancerous regions between treated and untreated patients （ t = 4.66, P 〈 0. 01 ）, But no difference existed between the treated and the control patients in noncancerous regions of prostate peripheral zone （ t = 0. 06, P 〉 0. 05 ）, in bladder and the obturator internus （ t = 0. 48, 1.64 ; P 〉 0. 05 ）. Conclusion Measurement of ADCs might be useful to evaluate the efficacy of endoerinotherapy for patients with prostate cancer.