前列腺癌的MRI表现

Analysis of MRI features in diagnosis of porstate carcinoma

目的:分析前列腺癌的MRI表现特点,以提高对本病的诊断能力。方法:收集经穿刺及术后病理诊断的前列腺癌29例,均行MRI检查,包括常规平扫、DWI、MRS,回顾性分析其MRI影像特点。结果:肿瘤病灶呈结节状,主要发生在前列腺周围叶(65.5%),少数在中央叶,2例呈弥漫分布。所有病灶T1WI为低信号,与正常前列腺组织低信号基本一致;T2WI大部分呈低信号结节,少数为等/稍高信号。DWI病灶为高信号,有2例呈稍高信号。病灶处MRS:Cho峰显著升高,Cit峰下降或消失,Cre峰变化不大,(Cho+Cre)/Cit(CC/C)比值升高(≥1.1)。其他:合并前列腺增生,侵犯邻近结构如膀胱、精囊腺、直肠、盆腔、腹股沟淋巴结增大并转移,骨盆、脊柱多处转移,少数伴肝脏转移。结论:前列腺癌T1WI不具诊断特征性,T2WI、DWI、MRS各有其特点,综合三者影像特点,可作为其诊断依据。

Objective To analysis the magnetic＇ resonance imaging （MRI） [eatures for prostate carcinoma （PCa）, and improve the ability of diagnosis. Methods 29 cases of PCa were confirmed by pathologyand under MRI scan. T1WI, T2WI, DWI and MRS features were analyzed retrospeetively. Results The tumors were nodular lesions, most of them located in prostate peripheral leaf（ 19 case, 65.5% ）, others in the central leaf （8 cases） and diffuse distribution （2 cases）. ALL lesions showed low signal intensity as normal prostate on TIWI, while most of the lesions were hypointensity, rare iso or slight byperinlensity on T2WI, and hyperintensity （2 cases slight hyperintensity） on DWI. On MRS, lesions made Cho wave marked rise, Cit wave decline or disappear, Cre wave little change, and （Cho ＋ Cre）/Cit （CC/C） rised （≥1.1）. Others, prostatic hyperplasia; seminal vesicle, bladder or rectum anterior wall invaded; basin wall and inguinal lymph node enlargement; pelvic, vertebral colum and liver metastasis were showed. Conclusion PCa has its eharacteristics on T2WI,DWI and MRS which can be comprehensive use for the diagnosis.