动态增强MR与PSA在前列腺癌诊断及鉴别诊断中的应用价值

目的：探讨MRI快速序列动态增强在前列腺癌(PC)诊断及鉴别诊断中的价值，并观察PSA在PC与前列腺增生(BPH)诊断中的作用。方法：对5例无泌尿系症状健康志愿者、经病理证实的13例前列腺癌和36例前列腺增生患者进行MR平扫、动态增强及延迟扫描，测量并计算病灶和正常组织的相对信号强度值，并绘制正常周围带(PZ)、PC与BPH三者的时间信号强度曲线。结果：PZ轻度强化，并缓慢上升至晚期达峰值；36例BPH早期明显强化并逐渐上升至中晚期达峰值后缓慢下降：13例PC9例早期明显强化，并快速下降，4例T2WI像上弥漫性病灶呈现中晚期强化。PC尤其是晚期患者的PSA值明显高于增生。结论：PZ、PC及BPH的动态强化方式明显不同，结合PSA可对PC的诊断与鉴别诊断起积极作用。

Dynamic contrast enhanced MRI and PSA for diagnosis and differentiation of prostate cancer

Objective:To assess the role of dynamic contrast enhanced MRI and PSA for diagnosis and differentiation of prostate cancer.Methods: Five volunteers with normal prostate, 36 patients with benign prostatic hyperplasia and 13 patients with biopsy-proven prostate cancer underwent MR imaging. Dynamic MR with bolus enhancement of GD-DTPA (gadolinium-diethylenetriamine pentaacetic acid) was performed. The singal intensity in dynamic MRI was measured and calculated, and the time-signal intensity curve of the normal peripheral zone and prostate cancer and benign hyperplasia was drawn. The PSA levels of prostate cancer and benign hyperplasia were compared.Results:In dynamic MRI, the normal peripheral zone were enhanced mildly and slowly, the peak value was located on late phase.The lesions in 36 patients with benign prostatic hyperplasia were enhanced obviously in early and gradually. The peak value was located on middle and late phase. The lesions in 9 of 13 patients with prostate cancer were enhanced obviously in early and washed out in late phase.Peak value was located on early phase. Specially, the PSA levels of the advanced prostate cancer were much higher than the benign hyperplasia's.Conclusion:In dynamic MRI, the enhancement of normal peripheral zone, prostate cancer and benign hyperplasia were different significantly,dynamic MRI and PSA was useful in diagnosis and differentiation of prostate cancer.