3.0T DCE-MRI在前列腺癌诊断中的应用价值

目的：分析前列腺癌(PCa)3.0T 动态增强磁共振成像(DCE-MRI)扫描特征,探讨 DCE-MRI 检查对 PCa 的诊断价值。方法对临床拟诊 PCa 患者行常规 MRI 平扫和 DCE-MRI 扫描,分析信号强度-时间(SI-T)曲线类型,并进一步计算到达峰值时间(Tmax)、最大强化程度(SImax%)和最快强化率(Rmax)。对前列腺进行标准化分区,比较穿刺证实阳性组(癌区)与阴性组(非癌区)各参数之间的差异,以及不同分化程度 PCa 之间的差异。结果活检发现 PCa 59例,26例未检出肿瘤证据,共有507个分区得到组织学证实,阳性组250个,阴性组257个。阳性组 SI-T 曲线以廓清型为主,阴性组 SI-T 曲线以上升型和平台型为主。Tmax、SImax%、Rmax 阳性组分别为(69.49±22.53)s、1.74±0.43、7.83±3.80,阴性组分别为(175.61±52.64)s、1.05±0.35、1.86±1.10,差异均有统计学意义(t =-24.24、16.34、17.75,P 均<0.01)。Tmax、SImax%、Rmax 高分化组(Gleason 评分2~6分)分别为(89.19±31.72)s、1.58±0.46、5.21±3.34,中低分化组(Gleason 评分7~10分)分别为(64.25±14.68)s、1.76±0.43、8.25±3.70,二者间差异均有统计学意义(t =7.09、-8.74、-7.83,P 均<0.01)。结论3.0T DCE-MRI 在 PCa 的诊断中具有重要价值。

The value of 3.0T DCE-MRI in the diagnosis of prostate cancer

Objective To analyze the characteristics of dynamic contrast enhanced MR imaging (DCE-MRI)in prostate cancer (PCa)at 3.0T,and to evaluate the diagnostic value of DCE-MRI.Methods 85 patients with suepected PCa received conventional MRI and DCE-MRI.The signal intense-time (SI-T)curve was analyzed.Then the time to maximum (Tmax),the maximum degree of enhancement (STmax%),and the rate of enhancement (Rmax)were calculated.The differences of styles of SI-T curve and the parameters between the positive and negative group were compared respectively.Results 59 cases of PCa were proved by biopsy,and there was no evidence of tumor in 26 cases.507 zones had histopathological results with 250 zones in positive group and 257 zones in negative group .The most common style of SI-T curve in positive group was rapidly ascending followed with descending curve,the most common style of SI-T curve in negative group was persistent ascending curve and plateau curve.The mean values of Tmax,SImax%,Rmax were (69.49±22.53)s,1.74±0.43,7.83±3.80 in positive group respectively,while (175.61±52.64)s,1.05±0.35,1.86±1.10 in negative group respectively,there were statistically significant differences between the two groups(t =-24.24,1 6.34,1 7.75,P <0.01)respectively. The mean values of Tmax,SImax% ,Rmax were (8 9 .1 9 ± 3 1 .7 2 )s,1 .5 8 ± 0 .4 6 ,5 .2 1 ± 3 .3 4 in the low-risk group (Gleason score 2 - 6 )respectively,while (64.25±14.68)s,1.76±0.43,8.25±3.70 in the high-risk group (Gleason score 7-10)respectively, there were statistically significant differences between them(t = 7.09,-8.74,- 7.83,P <0.01).Conclusion 3.0T DCE-MRI has great value in the diagnosis of PCa.