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目的探讨MRI扩散加权成像(diffusion weighted imaging,DWI)在前列腺癌诊断中的价值。方法经穿刺活检及手术组织病理证实前列腺癌患者27例及前列腺增生患者34例,于活检或手术前行MRI检查,分析DWI和表观弥散系数(apparent diffusion coefficient,ADC)图表现,测量前列腺癌病灶及中央腺体非癌灶区、前列腺增生外周带及中央腺体区增生结节的ADC值,并进行比较。结果前列腺癌在DWI图上表现为局限性高信号,在ADC图上表现为低信号;前列腺增生在DWI和ADC图上,外周带信号均较均匀,中央腺体信号欠均匀;前列腺癌病灶及中央腺体非癌灶区ADC值分别为(1.14±0.20)×10-3 mm2/s和(1.26±0.31)×10-3 mm2/s,前列腺增生外周带及中央腺体区增生结节的ADC值分别为(1.51±0.26)×10-3 mm2/s和(1.23±0.51)×10-3 mm2/s,前列腺癌病灶的ADC值低于前列腺增生外周带及中央腺体区增生结节(P<0.05)。结论在前列腺疾病诊断中,MRI与DWI是必要的检查手段,其中DWI对前列腺癌的诊断有重要价值。
Objective To investigate the value of MRI diffusion-weighted imaging (DWI) in the diagnosis of prostate cancer. Methods Twenty-seven cases of prostate cancer and 34 cases of benign prostatic hyperplasia were confirmed by biopsy and histopathology. MRI was performed before biopsy or surgery. DWI and apparent diffusion coefficient (ADC) were analyzed. Prostate cancer The ADC values of lesions and central gland non-cancerous zone, benign prostatic hyperplasia zone and central glandular hyperplastic nodules were compared and compared. Results Prostate cancer showed high signal on DWI and low signal on ADC. Prostatic hyperplasia was more uniform in peripheral zone and signal in central gland on both DWI and ADC maps. The ADC values of central glandular non-foci were (1.14 ± 0.20) × 10-3 mm2 / s and (1.26 ± 0.31) × 10-3 mm2 / s, respectively. Prostatic hyperplasia peripheral zone and central glandular hyperplastic nodules ADC values were (1.51 ± 0.26) × 10-3 mm2 / s and (1.23 ± 0.51) × 10-3 mm2 / s, respectively. The ADC values of prostate cancer lesions were lower than those in benign prostatic hyperplasia and central glandular regions (P <0.05). Conclusion In the diagnosis of prostate disease, MRI and DWI are necessary examination methods, of which DWI is of great value in the diagnosis of prostate cancer.