高场强磁共振成像对阴茎硬结症的诊断价值

Diagnostic value of high-field MRI for Peyronie's disease

目的：分析阴茎硬结症（Peyronie病）的MRI表现，探讨高场强MRI对阴茎硬结症的诊断价值。方法：14例临床确诊阴茎硬结症于我院行3．0TMRI检查的病例纳入研究，每例2～4次阴茎超声检查。MRI检查采用小表面线圈，检查序列包括常规及磁敏感加权成像（SWI）序列。将MRI结果与超声对照。结果：14例中MRI检查共发现25个硬结，其中3例炎性硬结（共7个）、4例纤维性硬结（共8个）、7例含钙化的混合性硬结（共10个），上述7例钙化结节于SWI均为低信号。超声可稳定检出含钙化的硬结（7例20次超声均检出，20／20），但不能准确判断炎性及纤维化硬结（7例23次超声发现3次，共6处纤维性硬结）。MRI需结合SWI序列才能判定有钙化的硬结；超声对炎性硬结（0／7例）和纤维性硬结（6／8例）的检出率均较MRI低。结论：高场强MRI检查对阴茎硬结症有较高的诊断敏感性及准确性，多序列成像可检出不同性质的硬结，有助于对阴茎硬结症的早期发现，为该病的诊断提供另一个检查选择。

Objective： To analyze the MRI manifestations of Peyronie＇s disease and investigate the value of high-field MRI in the diagnosis of the disease. Methods ： Using a small surface coil, we performed 3.0 Tesla MRI for 14 patients with clinically diag- nosed Peyronie＇s disease. The MRI protocol included routine sequences （T1WI, T2WI, and enhanced T1WI） and susceptibility- weighted imaging （SWI）. Each patient had received 2-4 penile ultrasound examinations previously. We compared the MRI findings with the results of ultrasonography. Results： MRI manifested 25 penile plaques in the 14 patients, 3 （7 plaques） with inflammation, 4 （8 plaques） with fibrosis, and the other 7 （10 plaques） with calcification displaying a low signal intensity on SWI. Uhrasonography had revealed the 10 calcified plaques in all the 20 examinations, but exhibited the 7 inflammatory and 8 fibrotic ones in only 3 of the 23 examinations. The combination of MRI SWI sequences was necessitated for the detection of calcified plaques and achieved higher detec- tion rates than ultrasonography for inflammatory and fibrotic plaques （ P 〈 0.05 ）. Conclusion ： High-field MRI has high sensitivity and accuracy in the diagnosis of Peyronie＇s disease, which can effectively display penile plaques of different nature in the early stage through multi-parametric sequences.