磁共振弥散成像对诊断前列腺癌的应用价值

Value of MR diffusion weighted imaging in the diagnosis of prostate cancer

目的探讨磁共振扩散加权成像对前列腺癌的诊断及鉴别诊断价值。方法收集经过手术或穿刺有病例结果的前列腺疾病患者111例,其中前列腺增生50例,前列腺癌61例。所有病例行磁共振弥散扫描,b值为1000 s/mm2,分析各病例病变组织的DWI表现,统计癌性病变与增生病变的DWI图像差别。结果 111例患者经手术或穿刺病理证实为前列腺癌61例,其中55例术前MRI诊断为前列腺癌的患者在DWI上呈明显高信号,并能直观显示肿瘤的范围,经术后病理证实为前列腺癌45例,诊断准确率为81.2%。结论磁共振DWI成像可清晰显示前列腺癌的位置和侵犯范围,根据信号特点以及ADC值明显提高前列腺癌的检出率及诊断准确性。并且对前列腺病变良恶性的鉴别诊断具有较高价值。

Objective To investigate the value of diffusion weighted imaging（DWI） in the diagnosis and differential diagnosis of prostate cancer. Methods All 111 patients who had pathological results via surgery and biopsy were included.Among them, 50 cases were proved with benign prostate hyperplasia and 61 patients with prostate cancer. All cases underwent MRI examinations, DWI was performed in all cases and the b values was 1000 s/mm2. The DWI findings of various groups were analyzed and the image differences between cancer and hyperplasia were statistically calculated.Results In 61 cases with cancer, 55 cases were diagnosed cancer by preoperative MRI, whose DWI showed high signal intensities and the locations and the extents of involvement of prostate cancers were clearly displayed. Within the 55 cases, 45 patients were pathologically confirmed with prostate cancer, the diagnostic accuracy was 81.2%. Conclusion MR DWI can clearly show the location and extent of prostate cancer. Based on the signal characteristics and the ADC value, the detection rate and diagnostic accuracy of prostate cancer are significantly improved. DWI has high value in the differential diagnosis of prostate benign and malignant lesions, particularly in the detection of prostate cancer in central gland which is very difficult to diagnose in routine T2WI.