多排螺旋CT对前列腺增生诊断的探讨

The value of MSCT on prostate disease

目的探讨多排螺旋CT对前列腺增生诊断及鉴别诊断价值。方法采用平扫、动脉期(30s)、静脉期(65s)、实质期(95s)、延迟期(180s)对22例前列腺增生患者进行多期扫描,所有病例均经病理或临床证实,分析其形态学及动态扫描CT表现。结果前列腺增生形态学表现:轻度增生呈栗子形,体积不大或轻度增大;明显增生呈类圆形或球形,体积明显增大;所有增生腺体均向膀胱底部形成深浅不同的压迹,明显增生腺体突入膀胱颈呈分叶状切迹;可并前列腺钙化、前列腺囊肿、膀胱结石、膀胱憩室、膀胱膨出、肾积水等;增生腺体均位于中央区,平扫密度均匀,未发现明显低密度区,CT值均数35.7±3.5HU;动态扫描表现:动脉期(30s,),以轻度强化为主,大部分呈均匀强化,CT值均数为50±10.4HU;静脉期(65s),呈明显强化,均匀与不均匀强化各占11例,CT值均数为67.2±12.3HU;实质期(95s),强化程度最高,CT值均数为70.1±7HU,大部分趋均匀强化或基本均匀强化;延迟期(180s),以明显强化为主,但强化程度较实质期已有所降低,CT值均数为68.8±8.2HU,大部分呈均匀强化,不均匀强化仅2例;前列腺增生的动态曲线呈缓升-平台型。结论多排螺旋CT多期动态扫描能全面观察前列腺增生的形态特征及动态变化规律,对前列腺增生的诊断及鉴别诊断具有重要意义。

Objective To analyze the CT signs of BPH, and to investigate the value of diagnosis and differential diagnosis of BPH by MSCT. Methods Multi-phase CT scanning including plain scan, arterial phase （35sec）, venous phase （65sec）, parenchymal phase （95sec）, lag period （180sec） scan after giving contrast medium was performed in 22 cases with BPH proven pathologically and clinically. CT signs of plain scan and dynamic scan were analyzed. Results Morphology of prostatic hyperplasia was： chestnuts like in lightly hyperplasia with nomal or slightly increased volumn; round in obviously hyperplasia with enlargeed volume; all the hyperplasia prostate impressed to the base of bladder, even with lobulated incisure of bladder neck. Symphyso-cyst of prostate, bladder stone, bladder diverticulum, vesicocele, hydronephrosis, etc may be combined. BPH located in the central of prostate. Uniform density showed in plain scan. CT value was 35.7_＋3.5HU; average CT value was 50.7±10.4HU in arterial phase, 67.2±12.3HU in venous phase, 70.1±7HU in parenchymal phase and 68.8±8.2HU in lag period scan, Densr-time-curve of BPH was slow- flatbed pattern. Conclusion MSCT is of important value in diagnosis and differential diagnosis of BPH for the morphologic characteristics and development of BPH can be evaluated thoroughly by it.