CT冠状面扫描在诊断前列腺癌中的应用价值

Efficacy of coronal prostate CT scan in the diagnosis of prostate carcinoma

目的 比较CT冠状位扫描和横断位扫描对前列腺癌的解剖结构和影像特征的显示 ,探讨CT冠状位扫描在前列腺癌诊断与鉴别诊断中的应用价值。方法 回顾性分析 6 0例手术、病理证实的前列腺癌患者的资料。术前均行CT冠状位扫描和横断位扫描 ,观察前列腺大小、密度、表面光滑度、包膜完整性、周围组织界限和有无转移等 ,并将CT表现与手术病理对照分析。结果 6 0例前列腺癌患者中 ,CT冠扫所显示的前列腺癌病灶的大小与手术结果基本一致 5 5例 ( 91.6 % ) ,轴扫 4 0例 ( 6 6 .7% ) (P <0 .0 5 ) ;CT冠扫能清楚显示密度差异 5 2例 ( 86 .7% ) ,轴扫 2 8例 ( 4 6 .7% ) (P <0 .0 1) ;表面光滑度 :5 8例手术证实前列腺表面呈结节状改变 ,CT冠扫显示此改变 4 9例 ( 84 .5 % ) ,轴扫 2 5例 ( 4 3.1% ) (P <0 .0 1) ;包膜完整性 :4 0例手术证实前列腺包膜不完整 ,CT冠扫显示不完整包膜 38例 ( 95 .0 % ) ,轴扫 2 1例 ( 5 2 .5 % ) (P <0 .0 1) ;周围组织界限 :4 2例手术证实前列腺癌与周围组织界限清楚 ,CT冠扫能清楚显示 39例 ( 92 .9% ) ,轴扫 2 1例 ( 5 0 .0 % ) (P <0 .0 1) ;周围转移 :18例手术证实前列腺癌对周围组织或远处有转移 ,CT冠扫显示转移 15例 ( 83.3% ) ,轴扫 7例 ( 4 6 .7% ) (P <0 .0 5 )。结论?

Objective To study the efficacy of prostate coronal CT scan in the diagnosis and differential diagnosis of prostate carcinoma , comparing the anatomic structures and imaging featare of prostate carcinoma on coronal prostate CT scan with those on axial. Methods The data of 60 patients with prostate carcinoma confirmed by surgery and pathology was analyzed retrospectively. All the patients performed both coronal prostate and axial CT scan before surgery. The size of carcinoma, the density differences in the prostate , the surface of the prostate, the integrity of the prostate capsule, the threshold of circumference constitution and metastasis depicted on the coronal and axial CT images were analyzed and compared with those from surgery and pathology. Results In the 60 patients with prostate carcinoma, the accuracy of coronal and axial CT scan was 91.6% (55/60) and 66.7% (40/60) in showing the size of prostate carcinoma ( P <0.05),and 86.7% (52/60) and 46.7% (28/60) in identifying the density differences in the prostate ( P <0.01), respectively. In 58 patients with nodular prostate confirmed by surgery, the accuracy of coronal and axial CT scan was 84.5% (49/58) and 43.1% (25/58) in depicting the nodular changes of prostate ( P <0.01), respectively. Within the 60 patients, 40 patients with focal carcinoma extruding the capsule of prostate were confirmed by surgery. The accuracy of coronal and axial CT scan was 95.0% (38/40) and 52.5% (21/40) in showing the prostate capsule changes ( P <0.01) respectively. The accuracy of coronal and axial CT scan was 92.9% (39/42) and 50.0% (21/42) in 42 patients with the clear threshold of circumference constitution( P <0.01); and 83.3%(15/18) and 46.7% (7/18) in 18 patients with local or distance metastasis ( P <0.05) respectively. Conclusion Coronal prostate CT scan is obviously superior to axial scan in depicting the structure, especially in tiny features of prostate carcinoma