磁共振弥散加权成像在鉴别前列腺良恶性肿瘤中的价值.pdfVIP

磁共振弥散加权成像在鉴别前列腺 良、恶性肿瘤中的价值 李伟 龙晚生 罗学毛 陈曼琼 兰勇 何义改 [摘要]目的 探讨磁共振弥散加权成像 (DWI)及表观弥散系数(ADC)在鉴别前列腺良、恶性 肿瘤中的价值。方法 对经病理或穿刺活检证实的22例前列腺癌、17例良性前列腺增生患者以及 20例健康志愿者行前列腺平扫MRI、DWI和增强MRI检查，并在工作站测量感兴趣区的ADC，对前 列腺癌、良性前列腺增生和正常前列腺的ADC进行统计学分析。结果 前列腺癌、良性前列腺增 生、正常前列腺在中央腺体和外周带的ADC分别为1.08±0.23、1.43±0.27、1.51±0.26和1.26± 0.47、1.72±0.40、1.75±0.28，前列腺癌的ADC明显低于良性前列腺增生和正常前列腺，差异有统计 学意义(P＜0.05)，而良性前列腺增生与正常前列腺比较差异无统计学意义(P＞0.05)。以前列腺中央 腺体和外周带的ADC分别是1.30和1.60为阈值来鉴别前列腺良、恶性肿瘤，具有较高的灵敏度和特 异度。结论 DWI及ADC的应用大大提高了MRI对前列腺良、恶性肿瘤的诊断和鉴别诊断能力。 前列腺肿瘤；前列腺增生；磁共振成像;弥散 ThevalueofMRdiffusionweightedimagingindifferentiatingbenignandmalignantlesionsof prostate LI WeiLONG Wan-shengLUO Xue-maoCHENMan-qiongLANYongHEYi-gai DepartmentofRadiology,JiangmenCentralHospital,GuangdongJiangmen529030,China [Abstract] Objective TostudythevalueofMRdiffusionweightedimaging(DWI)andapparent diffusioncoefficient(ADC)indifferentiatingbenignandmalignantlesionsofprostate.Methods Twenty-two patientswithprostatecancerand17patientswithbenignprostatichyperplasiaconfirmedbypathologyor biopsy,and20healthyvolunteerswereunderwentprostateplainMRI,DWIandenhancedMRI,and measuringthevalueofADCintheregionsofinterestintheworkstation,andtheADCvaluesofprostate cancer,benignprostatichyperplasia,normalprostatewereanalyzedstatistically.Results TheADCof prostatecancer,benignprostatichyperplasia,normalprostateincentralglandandperipheralzonewere 1.08±0.23,1.43±0.27,1.51±0.26and1.26±0.47,1.72±0.40,1.75±0.28,respectively,theADCof prostatecancerwassignificantlylowerthanthatofbenignprostatichyperplasiaandnormalprostate,and therewassignificantdifference (P＜ 0.05),buttherewasnosignificantdifferencebetweenbenignprostatic hyperplasiaandnormalprostate (P＞0.05).LookingtheADCwas1.30and1.60incentralglandand peripheralzoneasthethresholdtodistinguishbenignandmalignantlesionsofprostate,hadhighsensitivity andspecificity.Conclusion TheapplicationofDWIcombinedwithADC,hasimprovedthecapabilityof diagnosisanddifferentialdiagnosis