前列腺癌的CT诊断及评价

Evaluation of Computed Tomography in the Diagnosis of Prostatic Carcinoma

目的 评价CT在前列腺癌诊断及分期中的价值。材料与方法 回顾性分析经病理证实的 3 0例前列腺癌CT表现及其中 6例治疗后的CT表现 ,2 8例行平扫和增强 ,2例仅行平扫 ,扫描层厚和间距均为 5mm。由两位高龄CT诊断医师分析其CT表现 ,并进行CT分期。结果 3 0例前列腺癌中 ,前列腺边缘隆起者占 83 .3 3 % ,局限性前列腺密度减低或不均匀者占 90 % ,治疗前CT分期的准确率为 80 % ,Ⅲ期以上的准确率为 92 %。 6例去势治疗后 ,5例肿瘤明显缩小。结论 前列腺边缘结节状隆起和边缘毛糙 ,前列腺局限性密度减低是CT诊断前列腺癌的主要征象 ,CT对肿瘤的临床分期及治疗后疗效的评价具有较大的价值。

Objective To evaluate CT in the diagnosis and staging of prostatic carcinoma.Materials and Methods CT findings in 30 cases with pathologically proved prostatic carcinoma, as well as in 6 cases of them after treatment, were retrospectively analyzed. Using 5mm slice and 5mm interval, both plain and contrast enhanced CT scan were performed in 28 cases, while in 2 cases only plain CT scan was carried out. CT signs were analyzed, and staging of the tumor was made by two experienced radiologists.Results Nodular bulging of the prostatic margin and localized decreased density were seen in 83.33% and 90%, respectively, of the total 30 cases. Accurate rate in staging before treatment was 80%, while it was 92% for patients with stage Ⅲ or above Ⅲ. Significant reduction in tumor size was noticed in 5 of 6 patients after castration.Conclusion Nodular bulging and coarse of the prostatic margin, as well as localized lower density in the prostate, are characteristic CT signs of prostatic carcinoma. CT is of great value in staging of the tumor and in assessing the therapeutic response.