动态对比增强MRI定量分析鉴别不同级别前列腺癌

目的 观察阴囊内腺瘤样瘤的声像图表现，并分析超声误诊原因。方法 回顾性分析15例经手术病理证实的阴囊内腺瘤样瘤患者的术前超声资料，并与病理结果对照，分析其超声表现及误诊原因。结果 15例阴囊内腺瘤样瘤中，8例位于附睾尾部，5例位于附睾头部，2例位于睾丸；3例超声误诊为炎性改变，3例误诊为囊肿，2例误诊为恶性肿瘤，7例未定性。超声表现为实性（12例）或囊性（3例）肿块。实性肿块中，7例边界清晰、形态规则，5例边界欠清晰；其中6例内部回声均匀，6例内部回声欠均匀，可见无回声及点状强回声。囊性肿块均为多囊，其内可见分隔。15例中，8例可探及血流信号，7例未见明显血流信号。结论 阴囊内腺瘤样瘤的超声表现缺乏特异性，结合病史及其他影像学手段有助于减少误诊。

Quantitative analysis of dynamic contrast-enhanced MRI in distinguishing different grades of prostate cancer

Objective To investigate the value of quantitative analysis parameters of dynamic contrast-enhanced MRI (DCE-MRI) in distinguishing low or high grade prostate cancer. Methods Data of DCE-MRI in 26 patients with prostate cancer confirmed by surgical pathology following radical prostatectomy were retrospectively analyzed. These patients were divided into low grade prostate cancer (n=10) group or high grade prostate cancer group (n=16). The parameters, including transport constant (K^trans), rat constant (K_ep) and extravascular extracellular volume fraction (V_e) were measured and compared between the two groups. ROC curve was used to determine the efficacy of the parameters in distinguishing low or high grade prostate cancer. The correlation between the parameters and Gleason score were assessed. Results K^trans, K_epand V_e values in the low grade prostate cancer group was (0.22±0.07)/min, (1.24±0.57)/min and 0.21±0.08 respectively, and (0.36±0.10)/min, (1.82±0.66)/min, 0.21±0.10 respectively in the high grade prostate cancer group. The differences of K^trans and K_ep were statistically significant between the two groups (both P<0.05), while of V_e was not statistically significant (P=0.994). The area under ROC curves of K^trans and k_ep values for distinguishing low or high grade prostate cancers was 0.872 and 0.737, respectively. No correlation was found between any parameters nor Gleason scores (all P>0.05). Conclusion K^trans and K_ep, the quantitative analysis parameters of DCE-MRI, contribute to the differential diagnosis of low and high grade prostate cancer.