扩散加权成像对前列腺癌侵犯膀胱精囊的诊断价值初探

Diffusion-weighted imaging in prostate carcinoma with urinary bladder and seminal vesicle invasion

目的评价磁共振扩散加权成像(DWI)对前列腺癌(Pca)侵犯膀胱精囊的诊断价值。方法对30例精囊腺的Pca患者行DWI扫描,其中21例同时有膀胱侵犯。观察受侵犯的膀胱和精囊腺的DWI表现,分别测量Pca癌灶、受侵膀胱和精囊腺以及未受侵犯的膀胱壁和精囊腺的ADC值,并作统计学分析。结果本组Pca癌灶、受累膀胱及精囊腺DWI呈高信号影,ADC图呈低信号影。受侵膀胱、正常膀胱壁、受侵精囊、正常精囊腺和Pca癌灶的ADC值分别为(0.863±0.118)×10-3mm2/s、(1.524±0.151)×10-3mm2/s、(0.905±0.137)×10-3mm2/s、(2.795±0.212)×10-3mm2/s和(0.909±0.125)×10-3mm2/s。受侵膀胱的ADC值明显低于正常膀胱壁(t=14.472,P<0.05),受侵精囊的ADC值明显低于正常精囊腺(t=19.265,P<0.05),Pca癌灶与受侵膀胱和精囊腺的ADC值之间的差异无统计学意义(one-way ANOVE,F=1.394,P>0.05)。结论DWI有助于前列腺癌侵犯膀胱和精囊腺的诊断。

Objective To estimate the diagnostic value of diffusion weighted imaging （DWI） and the apparent diffusion coefficient （ADC） in demonstrating Pca with urinary bladder and seminal vesicle invasion （SVI）. Methods Thirty patients with Pca SVI were scanned with DWI, respectively. Among them, 21 cases with urinary bladder invasion simultaneously. DWI and ADC map appearance of all Pca foci, invaded urinary bladder, normal urinary bladder wall, SVI and normal seminal vesicle were analyzed, and their ADC values were measured. Results All Pca foci, invaded urinary bladder and seminal vesicle showed high signal intensity on DWI and low signal intensity on ADC map. The mean ADCs for invaded urinary bladder, normal urinary bladder wall, SVI, normal seminal vesicle and Pca foci were （0.863±0.118）×10-3 mm2/s, （1.524±0.151）×10-3 mm2/s, （0.905±0.137）×10-3 mm2/s, （2.795±0.212） ×10-3 mm2/s and （0.909±0.125）×10-3 mm2/s respectively. The ADC values of invaded urinary bladder were lower than those of normal urinary bladder wall （t=14.472,P〈0.05）. The ADC values of SVI were lower than those of normal seminal vesicle （t=19.265,P〈0.05）. There was no significant difference between the ADC values of Pca foci, invaded urinary bladder and SVI （one-way ANOVE, F=1.394,P〉0.05）. Conclusion DWI plays a useful role in diagnosis of Pca with urinary bladder and seminal vesicle invasion.