DCE-MRI与DWI对良恶性前列腺疾病诊断的价值

Evaluation of MR Imaging with Dynamic Contrast-enhancement and Diffusion-weighted Imaging in Diagnosis of Prostatic Diseases

目的探讨动态增强MRI(DCE-MRI)及扩散加权成像(DWI)对前列腺良恶性疾病的诊断价值。资料与方法对15名正常自愿者及48例经病理证实的前列腺疾病患者行MRI常规平扫、DWI及DCE-MRI,分析正常前列腺内外带、前列腺增生症(BPH)及前列腺癌(PCa)的DEC-MRI信号变化,时间信号-强度(SI-T)曲线特征及表观扩散系数(ADC)值的变化情况。结果DCE-MRI及DWI对良恶性前列腺疾病的检出具有较高的敏感性及特异性。达峰时间(Tmax)从高到低依次为正常前列腺外周叶、正常中央叶、BPH及PCa(P=0.000);强化程度(SI%)从高到低为BPH,正常中央叶、PCa及正常外周叶(P=0.000);强化率(R)从高到低为PCa、BPH、正常中央叶及正常外周叶(P=0.000)。ADC值从高到低为正常外周叶、正常中央叶、BPH及PCa(P=0.000)。结论DCE-MRI及DWI可明显提高PCa及BPH的鉴别诊断率。

Objective To evaluate the value of MR imaging with dynamic contrast-enhancement （DCE） and diffusion-weighted imaging （DWI） in diagnosis of prostatic diseases. Materials and Methods Fifteen healthy volunteers,24 BPH and 24 PCa were scanned with conventional MR imaging,dynamic enhancement and DWI,All the BPH and PCa were proved by pathology. the alteration of DCE-MRI signal intensity,the characteristics of signal intensity-time curve （SI-T curve） and the ADCs. Results The peak time（Tmax） ranking from hige to low were the normal peripheral zone,central gland,BPH nodules and PCa focus（ P =0.000）. The enhancement rate was reverse（ P =0.000）; the enhancement degreen ranking from hige to low were BPH nodules,the normal central gland,PCa focus and normal peripheral zone （ P =0.000）.The mean ADCs ranking from hige to low are the normal peripheral zone,central gland,BPH nodules and PCa focus. Conclusion DCE-MRI and DWI were helpful to diagnose and differentiate prostate diseases.