10例前列腺脓肿患者的磁共振扩散加权成像诊断分析

Multi-parametric MRI diagnosis of ten patients with prostate abscess:diagnostic value of diffusion-weighted imaging

目的探讨磁共振扩散加权成像(DWI)对前列腺脓肿的诊断价值。方法回顾性分析2015年1月—2017年11月华北理工大学附属医院经穿刺或细菌培养确诊的10例前列腺脓肿的临床资料,均行多参数磁共振成像扫描(含DWI序列),7例进一步行增强MRI检查。结果磁共振扩散加权成像检查结果显示,10例前列腺脓肿中3例为单发型,位于周围区一侧;7例为多发型,同时累及周围区和中心区。脓肿T1WI呈稍低信号或低信号,T2WI呈高信号或较高信号,DWI表现为扩散明显受限,呈典型高信号,ADC呈明显低信号。脓肿壁增强扫描检查时,表现为脓腔壁呈环状明显强化有5例,2例呈脓腔壁中等程度强化,部分脓腔内见强化分隔4例,脓肿腔内未见强化,5例脓肿腔内见分隔强化,与脓肿壁的强化一致。结论MRI弥散加权成像可作为前列腺脓肿诊断的重要检查及诊断方法,其特征是信号明显偏高。增强MRI能更清晰地显示脓肿壁和脓肿的分离部位,明确脓肿位置及扩散范围,对于鉴别前列腺脓肿与其它前列腺病变具有独特优势。

Objective To observe the value of multi-parametric MRI,especially diffusion-weighted imaging(DWI),in the diagnosis of prostate abscess.Methods A retrospective analysis of ten cases of prostate abscess confirmed by puncture or bacteriological culture of antibiotics in the Affiliated Hospital of North China University of Science and Technology from January 2015 to November 2017 was performed.All patients underwent multi-parametric MRI(DWI),and 7 of them underwent enhanced MRI.Results Of the ten cases of prostate abscess,three cases showed a single hair style,located in one side of the peripheral zone,seven cases were multiple hair styles,and the peripheral zone and the central zone were involved at the same time.Abscess T1WI showed a slightly low signal or a low signal,and T2WI showed a slightly high signal or a high signal.DWI showed a significantly limited diffusion,a typical high signal;and ADC showed a significantly low signal.In enhanced MRI of abscess wall,there were five cases with obvious ring-shaped enhancement of abscess wall,two cases with moderate enhancement of abscess wall,four cases with enhanced separation in partial abscess cavity,and no enhancement in the abscess.There were five cases with enhanced separation in abscess cavity,which was consistent with the enhancement of abscess wall.Conclusions MRI(DWI)can be used as an important examination and diagnostic method in the diagnosis of prostatic abscess.Enhanced MRI scan can more clearly distinguish the abscess wall and separation;determine the location and spread of abscesses.Enhanced MRI has a unique advantage in distinguishing the prostatic abscess from other prostatic lesions.