急性前列腺炎合并前列腺癌的MR表现

MR features of acute prostatitis combined with prostate cancer

目的探讨急性前列腺炎合并前列腺癌的MR表现。方法回顾性分析15例急性前列腺炎合并前列腺癌患者的MRI(n=15)、DWI(n=10)及DCE(n=5)资料。7例患者在接受抗感染治疗、临床症状消失后复查DWI。结果抗感染治疗前,15例患者前列腺中央带或外周带显示为弥漫性低信号,中央带及外周带分界显示不清,包膜模糊;10例患者的DWI图像可见明显高信号,ADC图可见明显低信号;5例接受动态增强患者显示为典型的流出型曲线。7例接受抗感染治疗的患者除T2WI水肿表现消失,外周带弥漫性低信号区范围缩小外,DWI和ADC图的相应区域仍可见高信号和低信号。结论 MRI常见的局灶性或弥漫性低信号并不具有特征性,水肿的存在是急性炎症的特异表现;DWI影像学特点未因前列腺炎的治愈而发生变化,因此在前列腺癌的诊断上可能较动态增强更可靠。

Objective To investigate the MR features of prostatitis combined with prostate cancer.Methods Data of conventional MRI(n=15),DWI(n=10)and dynamic contrast-enhancement(DCE;n=5)of patients with acute prostatitis combined with prostate cancer was analyzed.Seven patients underwent MRI and DWI after therapy.Results Before the treating,MRI(n=15)showed low signal in central or peripheral zone,boundary of central and peripheral zone was not clear,envelope was fuzzy;DWI(n=10)showed high and low signal on ADC map;DCE(n=5)displayed with typical curve of wash-out type.After the treating,7 patients underwent MRI and DWI,except the edema disappeared and peripheral zone with diffuse low signal area was narrow,high and low signal in DWI and ADC were still visible.Conclusion Focal or diffuse low signal in MRI is not specific,edema is characteristic in acute prostatitis.The features of DWI and ADC have no change before and after therapy,which are more reliable to diagnose prostate cancer than DCE.