T_2WI低信号的前列腺外周带病变的MR诊断研究

MR diagnosis of peripheral zone of prostatic diseases with low intensity in T_2WI

目的:探讨磁共振T2加权相(T2WI)表现为低信号的前列腺外周带病变的诊断研究。方法:对83例前列腺外周带病变,其中前列腺炎症25例、前列腺腺癌45例、前列腺增生10例、纤维化病灶3例,进行T1WI、T2WI、DWI扫描,其中55例进行了增强扫描,分析前列腺外周带病变的信号表现。所有病例均经手术或穿刺活检病理证实。同时分析83例患者的PSA值。结果:前列腺外周带炎症T2WI的低信号影大部呈斑片状,无占位效应,增强后时间-信号曲线呈平台型,DWI呈稍高信号,ADC值稍减低,血PSA值处于正常值上限附近;前列腺外周带癌灶T2WI的低信号影以结节状为主,增强后时间-信号曲线呈速升速降型,DWI呈明显高信号影,ADC值明显降低,血PSA值明显增高;前列腺外周带良性前列腺增生T2WI的低信号呈斑片状或结节状,增强后早期无明显强化,后期不均匀强化,DWI呈稍高或高信号,ADC值稍低,介于腺癌与炎症之间,常可见中央带增生表现,血PSA值稍高;前列腺外周带纤维化病灶T2WI的低信号呈斑条状,界清,DWI呈低信号,增强后无强化,血PSA值正常。结论:前列腺外周带的炎症、腺癌、增生、纤维化病灶T2WI均可表现为低信号,增强扫描及DWI检查,ADC值测量,并结合PSA值,有较大诊断价值。

Objective： This study was to evaluate the the diagnosis of peripheral zone of prostatic disease with low intensity in T2 WI. Methods： Analyzed of 83 cases of peripheral zone of prostatic disease,include 25 prostatitis, 45 PCa, 10 BPH, and 3 fibrotic lesions. They were all scanned with T1 WI, T2WI, DWI, and 55 cases were enhanced scanned. Their intensity characteristics were analyzed respectively. All the cases have histological diagnosis. Results： Peripheral zone of prostatic disease appearance The low intensity in T2WI of peripheral zone with prostatitis showed patchy, unclear border, and the time-signal intensity curve is a plat form-type signaluous, the mean ADCs were low slightly, and PSA level of prostatitis were in upper limit of normal PCa showed nodular, and the time-signal intensity curve is a rise-downhilltype, the mean ADCs were low significantly, while their PSA level were high significantly BPH nodules showed patchy or nodular, late enhanced, the mean ADCs were low slightly, and their PSA level within the PCA and prostatitis; Fibrotie lssions showed strip, clear border, and non-enhanced, and PSA level were normal. Conclusion： Shape, DWI, the mean ADCs, and PSA level for prostatitis, PCa, BPH, and fibrotic lssions demonstrate a significant difference, and that can be used in the differential diagnosis of peripheral zone of prostatic disease with low intensity in T2 WI.