核磁共振动态增强扫描在前列腺癌诊断及鉴别诊断中的应用价值

目的 通过绘制时间信号强度曲线，探讨磁共振成像(MRI)快速序列动态增强在前列腺癌诊断及鉴别诊断中的价值。方法 对6例无泌尿系症状健康对照者、13例经病理证实的前列腺癌及32例前列腺增生患者行MR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、前列腺癌及增生的时间信号强度曲线。结果 正常周围带轻度强化，并缓慢上升至晚期(300s)达峰值(信号强度0．94～1．02)；32例前列腺增生患者于60s明显强化(信号强度1．11～1．29)并逐渐上升至240s时达峰值(信号强度1．50～1．68)后缓慢下降；13例前列腺癌患者中9例于60s时明显强化(信号强度1．30～1．j1)，并快速下降，4例T2WI影像上弥漫性病灶240～300s时明显强化。结论 正常周围带、前列腺癌及前列腺增生的动态强化方式明显不同，应用MR动态增强扫描对前列腺癌的诊断与鉴别诊断有较大的价值。

To assess the value of dynamic contrast-enhanced MRI for diagnosis and difteretial diagonis of prostatic cancer

Objective To assess the role of dynamic contrast-enhanced MRI for diagnosis and differential diagnosis of prostatic cancer. Methods Six volunteers, 32 patients with benign prostatic hyperplasia and 13 patients with biopsy-proven prostatic cancer underwent MR imaging. Dynamic MR with Gd-DTPA (gadolinium-diethylene triamine pentaacetic acid) bolus enhancement was performed followed by post-contrast T 1-weighed imaging. The signal intensive value in dynamic MRI was measured and calculated to draw the time-signal intensity curve of normal peripheral zone, prostatic cancer and benign hyperplasia. Results In dynamic MRI, the normal peripheral zone were enhanced mildly and slowly. The lesion enhancement of benign prostatic hyperplasia in 32 patients were obvious in early phase (60 s) and strengthened gradually, and then went to decrease in late phase (240 s) after peak value. The lesions in 9 of 13 cases with prostate cancer were enhanced obviously in early phase (60 s) and washed out rapidly in late phase, and the peak value was located on early phase. Conclusions In dynamic MRI, the enhancement of normal peripheral zone, prostate cancer and benign hyperplasia were different significantly. Dynamic MRI was very useful in the diagnosis and differentiation of prostate cance.