前列腺癌和增生的MRI与病理对照研究

目的 研究前列腺癌不同ＭＲＩ表现的病理基础，以提高ＭＲＩ对前列腺癌和增生诊断的准确性。方法 观察经病理证实的４３例前列腺癌和４０例增生患者的前列腺形态及信号改变，并加以比较，前列腺癌组中１７例取前列腺左右两侧外周区上中下、左右移行区上下共１０点进行穿刺，对穿刺组织分别进行病理检查，同时计算癌变组织占总穿刺体积的百分比，并与其ＭＲＩ进行对比。结果 前列腺癌形态规则３１例，不规则１２例，增生组分别为３

Prostaticcarcinoma and benign prostatic hyperplasia: MR imaging with histopathologic correlation

Objective To understand the pathologic basis of various MR findings of prostatic carcinoma and to improve the diagnostic accuracy of prostatic carcinoma and benign hyperplasia Methods Forty three patients with prostatic adenocarcinoma and 40 patients with benign hyperplasia were studied All cases were proved histopathologically In 17 cases of cancer group, prostatic biopsies under BUS were performed routinely at 10 points(upper, middle and lower peripheral zone of left and right sides, upper and lower transient zone of left and right sides), then the pieces of biopsied tissue were given histopathologic examinations respectively Meanwhile, the percentage of cancer tissue in all of the biopsied tissue was calculated MR findings were correlated with the pathologic results in these 17 patients Results Prostatic shapes were regular in 31 cases and irregular in 12 cases in cancer group and 39 cases and 1 case in hyperplasia group On axial T 2WI, the peripheral zones in cancer group manifested as: (1) diffuse hypointense signal and zonal architecture disappearance: 22 cases, biopsies were given in 8 cases and the cancer tissue accounted for 86% of all the biopsied tissue on average; (2) hypointense nodules: 2 cases, 1 case received biopsy and the cancer tissue accounted for 10% of the biopsied tissue; (3) partial hypointense signal: 9 cases, the cancer tissue accounted for 47 5% on average in 4 biopsied cases; (4) diffuse decreased signal intensity with existing zonal anatomy: 8 cases, the cancer tissue accounted for 6 5% on average in 4 biopsied cases; (5) normal signal intensity: 2 cases, their pathologic results of biopsy were benign hyperplasia but local early carcinoma was detected after surgery In hyperplasia group, all of the above manifestations could be found and the numbers of cases were 8, 1, 3, 16, and 12,respectively Some of them were difficult to be differentiated from prostatic carcinoma Conclusion Based on prostatic shape and signal intensity of peripheral zone on axial T 2WI, MRI diagnostic accuracy of prostatic carcinoma was 79 5% with the sensitivity of 81 0% and the specificity of 78 0% In combination with anus finger touch and PSA value, the diagnostic accuracy could be improved