前列腺癌动态增强MRI的多样性表现及特点

目的 探讨前列腺癌的动态增强MRI特征,评估MR动态增强扫描诊断前列腺癌的价值。方法 对44例前列腺癌疑诊患者行3.0T MR LAVA动态增强扫描,将信号强度-时间(SI-T)曲线分为持续缓升型、缓升平台型、速升平台型和速升缓降型4种,并计算曲线强化程度(SI_peak%)和最快强化率(R_max)。比较穿刺阳性与阴性病灶(阳性组、阴性组)之间、中高分化腺癌与中低分化腺癌之间强化参数的差异。结果 44例患者共87个前列腺侧叶获得组织学证实,阳性组53个(Gleason Score 2~6者7个;Gleason Score 7~10者46个),阴性组34个。阳性组中速升平台型(26/53,49.06%)和速升缓降型(17/53,32.08%)曲线最常见,阴性组中持续缓升型(24/34,70.59%)曲线最常见。阳性组的SI_peak%、R_max分别为(2.04±0.52)%、(35.09±15.79)%;阴性组分别为(1.38±0.55)%、(17.39±9.69)%,差异均有统计学意义(P均<0.001)。中高分化腺癌的SI_peak%、R_max分别为(1.55±0.54)%、(21.20±14.97)%;中低分化腺癌分别为(2.12±0.48)%、(37.20±14.95)%(P均＝0.01)。结论 前列腺癌MR动态增强多表现为早期快速强化,分化较差腺癌常比分化较好的腺癌表现出更强及更快的早期强化。

Diversity and characteristics of prostate cancer in dynamic contrast-enhanced MRI

Objective To investigate the MR enhancing characteristics of prostate cancer, and to observe the diagnostic value of dynamic contrast-enhanced MR imaging (DCE-MRI) for prostate cancer. Methods Forty-four patients with suspected prostate cancer underwent liver acceleration volume acquisition (LAVA) DCE-MRI with 3.0T MR system. The shapes of signal intensity-time (SI-T) curve were defined as type A (persistently and slowly ascending curve), B (slowly ascending followed with plateau curve), C (rapidly ascending followed with plateau curve) and D (rapidly ascending followed with descending curve). The whole enhancement degree (SI_peak%) and the relative maximum slope (R_max) were also calculated. The styles of SI-T curve of the positive and negative group, means cancerous and non-cancerous group were analyzed, respectively. SI_peak% and R_max were compared between the groups as well as between well-differentiated cancer and poor-differentiated cancer. Results In 44 patients, 87 peripheral zones (PZs) were pathologically proved, 34 had no evidence of cancer, and 53 were proved prostate cancer (7 with good-differentiated cancer, 46 with poor-differentiated cancer). The most common styles of SI-T curve in positive group were type C (26/53, 49.06%) and D (17/53, 32.08%). The most common style of SI-T curve in negative group was type D (24/34, 70.59%). SI_peak% and R_max of positive group was (2.04±0.52)% and (35.09±15.79)%, respectively; and those of negative group was (1.38±0.55)% and (17.39±9.69)%. There were significant differences between two groups (both P<0.001). In addition, SI_peak% and R_max was (1.55±0.54)%, (21.20±14.97)% for the well-differentiated cancer and (2.12±0.48)%, (37.20±14.95)% for the poor-differentiated cancer, significant differences were noted between them (both P=0.01). Conclusion The early rapid increase of SI observed in SI-T curve is common in prostate cancer, and the early enhancement is higher and faster in poor-differentiated cancer than in well-differentiated cancer.