磁共振扩散加权成像在前列腺癌检出和鉴别诊断中的价值

目的评价磁共振扩散加权成像（DWI）序列在前列腺癌检出和鉴别诊断中的价值。方法本研究包括87例患者,41例为前列腺癌,46例为良性前列腺增生。所有病例在3.0TMRI系统接受常规T2WI、动态增强T1WI（DCE-MRI）和DWI扫描（b值取0和1000s/mm2）。在前列腺癌组,分别在肿瘤和无肿瘤区设置兴趣区并测量ADC值。在增生组,分别在前列腺中央区和外周带测量ADC值。结果肿瘤组良、恶性前列腺组织的平均ADC值分别为（0.97±0.25）×10-3mm2/s和（1.34±0.16）×10-3mm2/s。在增生组,中央区和外周带的ADC值分别为（1.37±0.24）×10-3mm2/s和（1.43±0.31）×10-3mm2/s。恶性前列腺组织的平均ADC值显著低于肿瘤组和增生组中良性前列腺组织（P〈0.001）;肿瘤组中良性组织与增生组之间的ADC值无显著性差异。结论 DWI检查和ADC值有助于发现前列腺癌,尤其是发生于前列腺尖部和中央区的早期前列腺癌。T2WI结合DWI可提高前列腺癌的检出率。

Diffusion-weighted imaging in the detection and differentiation of prostate cancer

Objective：To determine the value of diffusion-weighted imaging （DWI） for the detection and differentiation of the prostate cancer.Materials and Methods：87 patients were included in the study.41 cases were confi rmed pathologically to be prostate cancer and 46 to be benign hyperplasia （BPH）.Axial T2WI,DWI and DCE-MRI were performed under a 3.0 T MRI scanner.An echo-planar imaging DWI technique with b=0 and b=1000 s/mm2 were used.In cancer group,the ADC values were measured in malignant and benign tissues using regions of interest （ROI）.In BPH group,the ADC values were measured in both transitional zone （TZ） and peripheral zone （PZ）.Results：Among 41 cancer patients,tumors located in PZ in 28 patients,in TZ in 5 patients,tumors involved both PZ and TZ in 8 patients.The size of the smallest tumor which can be measured in ADC map was 0.8 cm.The mean ADC values of the malignant and benign tissues in the cancer group were （0.97 ± 0.25）×10-3 mm2/s and（1.34 ± 0.16）×10-3 mm2/s.The mean ADC values of PZ and TZ in the BPH group were （1.37 ± 0.24）×10-3 mm2/s and（1.43 ± 0.31）×10-3 mm2/s,respectively.The mean ADC value of the malignant tissue was signifi cantly lower than the benign tissues in cancer group and in BPH group as well （P0.001）,while no significant difference was observed between the benign tissue in cancer group and those in BPH group.Conclusion：DWI and ADC value could help to detect and differentiate prostate cancer with hyperplasia.T2WI combined with DWI may increase the detection of prostate cancer,especially in the apex and transitional zone.