培训课件--男性生殖系统.pptVIP

Biopsy-proved adenocarcinoma A 58-year-old man with a PSA level of 50.0 ng/mL T2WI axial and sagittal images reveal a large tumor (T) that invades the entire prostate gland and demonstrate gross extracapsular extension and direct invasion of the urinary bladder and seminal vesicles Biopsy-proved adenocarcinoma A 62-year-old man with a PSA level of 15.1 ng/mL T2WI axial and sagittal images demonstrate diffuse tumor invasion of the prostate gland with direct tumor (T) extension to the wall of the urinary bladder and the anterior rectal wall. The multiple low-signal-intensity lesions in the pubic bones are consistent with bone metastases * 前列腺癌 前列腺癌--右侧膀胱精囊角变钝 前列腺癌 前列腺癌 前列腺癌 前列腺癌 前列腺癌 前列腺癌 前列腺癌 前列腺癌 前列腺癌 前列腺癌 前列腺癌 前列腺癌 前列腺癌 前列腺癌复发 前列腺癌转移 Prostate cancer MRI对发现癌和确定其大小、范围有较高价值 T1WI癌与前列腺组织均为一致性较低信号，难以识别 T2WI前列腺癌典型表现为正常较高信号的周围区内出现较低信号结节影，肿瘤与周围区正常前列腺组织有显著差异，易于发现早期肿瘤 5㎜以上前列腺癌的发现率为60% 限度是不能发现起于移行区的早期前列腺癌，因其信号强度类似于周围组织，除非肿瘤侵犯了周围区而在T2WI得以显示 Prostate cancer MRI检查是确定前列腺癌的最佳检查方法，前列腺被膜有无破坏、突破，对于临床是否采取手术治疗和估价预后非常重要 正常前列腺被膜应是光滑连续的，一旦被膜连续性中断或局部病变组织外突均指示被膜破坏 病变延伸至被膜外的其他表现有指肠前列腺间隙显示，前列腺周围脂肪内出现低信号影，前列腺周围的神经血管丛发生移位且信号发生改变 精囊受累时， 受累精囊增大并T2WI信号减低 还可发现转移所致的盆腔淋巴结及其它部位的淋巴结增大，易于发现其他器官和骨转移 前列腺癌MRI表现 前列腺变形，局限性向外隆起，或外形呈分叶状 T2WI在高信号的外周带内见一低信号缺损区；T1WI上信号变化不明显 精囊受侵征象：膀胱精囊角变钝或消失，两侧明显不对称；T2WI上信号降低 在T1WI上见前列腺周围高信号脂肪影内出现低信号区，则提示为癌肿向周围侵犯 盆腔内可见异常肿大的淋巴结 MR Appearance of Prostate Cancer On T2WI, prostate cancer usually demonstrates low signal intensity in contrast to the high signal intensity of the normal peripheral zone. Low signal intensity in the peripheral zone, however, can also be seen in several benign conditions, such as hemorrhage, prostatitis, hyperplastic nodules, or posttreatment sequelae (eg, as a result of irradiation or hormonal treatment) Postbiopsy hemorrhage axial T1WI and T2WI and coronal T2WI demonstrate extensive bilateral postbiopsy hemorrhage in the peripheral zones. The transition zone in the left lobe demonstrates high signal intensity on the T1WI and low signal intensity on th