64排螺旋CT灌注成像对前列腺疾病的诊断价值

Value of 64-row Spiral CT Perfusion in the Diagnosis of Prostatic Disease

[目的]分析前列腺疾病的螺旋CT灌注成像特点，探讨其对前列腺疾病的鉴别诊断价值。[方法]选取本院收治的130例前列腺疾病患者进行64排螺旋CT扫描，其中前列腺增生（BPH组）患者72例，前列腺癌（PCa组）患者58例。对比各组灌注参数之间的差异，观察BPH组和PCa组的CT强化峰值到达时间，计算上升段斜率并进行分析。[结果]BPH组增强图像显示，60例患者前列腺普遍表现为均匀强化，PCa组增强图像显示，48例明显强化，45例前列腺双侧外周区不对称。BPH组与PCa组的血流量（BF）、血容量（BV）、毛细血管通透性（PS）以及达峰时间（TTP）的差异均无统计学意义（P〉0．05）。PCa组的平均通过时间（MTT）小于BPH组，差异有统计学意义（P〈0．05）。PCa组的强化峰值出现时间早于BPH组，且差异有显著性（P〈0．05）。PCa组时间、密度曲线（TDC）的上升斜率大于BPH组。[结论ICT灌注成像能够反映PCa与BPH不同的动态强化过程，为前列腺疾病的早期CT诊断及鉴别诊断提供理论依据。

[Objective] To analyze the features of spiral CT perfusion imaging of prostatic disease, and explore its value in the differential diagnosis of prostatic disease.[Methods]A total of 130 patients with prostatic diseases in our hospittrl were chosen and received 64-row spiral CT scanning. Among all patients, 72 patients were benign prostatic hyperplasia（BPH group） and 58 patients were prostate cancer（PCa group）. The difference of perfusion parameters were compared between two groups. CT intensified peak time in BPH group and PCa group was observed. The elevation slope was calculated. [Results] The enhancement images of group BPH showed that 60 patients presented homogeneous enhancement of prostate generally. The enhancement images of group PCa showed that 48 patients presented the obvious enhancement. The prostate of bilateral peripheral zone of 45 patients were asymmetric. There was no significant difference in BF, BV, PS and TTP between group BPH and group PCa（ P 〉0.05）. MTT in group PCa was lower than that in group BPH, and there was significant difference（ P 〈0.05）. The intensified peak time of group PCa was earlier than that of group BPH, and there was significant difference（ P〈0.05）. The elevation slope of group PCa was higher than that of group BPH. [Conclusion] CT perfusion imaging can reflect the process of dynamic intensification of PCa and BPH. It provides the theoretical basis of CT for the early diagnosis and differential diagnosis of prostatic disease.