多层螺旋CT灌注成像对前列腺增生与前列腺癌的鉴别诊断分析

Analysis on MSCT perfusion imaging in differential diagnosis of BPH and PCa

目的:分析多层螺旋CT(MSCT)灌注成像对前列腺增生(BPH)与前列腺癌(PCa)的鉴别诊断价值。方法:选取医院收治的60例经病理学证实的前列腺病变患者,依据病理学诊断结果将其分为BPH组(32例)和PCa组(28例),所有患者均行MSCT灌注成像扫描,测定比较两组患者血流量(BF)、血容量(BV)、平均通过时间(MTT)及表面通透性(PS)等灌注参数值变化。结果:BPH组患者灌注成像扫描图像表现为中央带明显增大,呈高灌注,中央带与外周带界限清楚,且部分患者累及中央带及外围带,呈均匀高灌注;PCa组患者灌注成像扫描图像表现均呈高灌注和早期强化,BV、BF及PS病变组织为红至黄色,MTT为绿至蓝色;相对血容量(rBV)、相对血流量(rBF)及PS值均显著高于BPH组,差异有统计学意义(t=8.295,t=15.522,t=13.614;P<0.05),两组MTT值比较差异无统计学意义。结论:MSCT灌注成像能够反映BPH和PCa不同强化过程,为前列腺疾病诊断和鉴别诊断提供依据。

Objective:To analyze the value of multi spiral computed tomography(MSCT)perfusion imaging in the differential diagnosis of benign prostatic hyperplasia(BPH)and prostate cancer(PCa).Methods:60 patients with prostatic lesions who were confirmed by pathology and admitted to hospital were analyzed retrospectively.They were divided into BPH group(32 cased)and PCa group(28 cases)according to diagnostic results of pathology.All of patients underwent MSCT perfusion imaging scan,and the changes of a series of perfusion parameters included the blood flow(BF),blood volume(BV),mean time of passage(MTT)and surface permeability(PS)of two groups were determined and compared.Results:The appearances of the scan images of perfusion imaging of BPH group showed that the central zone was obviously enlarged and was high perfusion,and the boundary between the central zone and the peripheral zone was clear,and the lesions of some patients involved the central zone and the peripheral zone,and these lesions showed uniform high perfusion.The appearances of the scan images of perfusion imaging of PCa group showed high perfusion and early enhancement,and the colors of BV,BF and PS of tissues with lesion appeared from red to yellow,and those of MTT was from green to blue in PCa group.The values of relative BV(rBV),relative BF(rBF)and PS in PCa group were significantly higher than those in BPH group(t=8.295,t=15.522,t=13.614,P<0.05),and the difference of MTT value between the two groups was not statistically significant.Conclusion:MSCT perfusion imaging can reflect the different enhancement process of BPH and PCA,and can provide the basis for the diagnosis and differential diagnosis of prostatic diseases.