MRI对前列腺中央腺体T2WI低信号结节的良恶性分析

目的:探讨前列腺中央腺体T2WI低信号良、恶性结节的MRI表现,以提高鉴剐诊断的能力.方法:符合纳入标准的19例前列腺癌结节和61例前列腺增生患者经多序列MRI检查并经组织病理学证实.对两者在T2WI上的信号和边缘.DWI信号强度和ADC值、及多期DCE的最大信号强度和时间信号强度曲线的类型进行比较分析.结果:19例前列腺癌结节T2WI上边界不清、部分不清16例,边缘清楚3例,呈均质低信号;61例前列腺增生结节边缘不清及部分边界不清共34例,边缘清楚27例,信号均匀30例,信号不均匀31例.两者具有显著性的差异(P=0.007).于DWI,前列腺癌结节信号强度(b值为800 s/mm2)为60.6±10.7明显高于增生结节(49.7±8.5)(t值为 5.793,P=0.00).前列腺癌结节ADC值为(0.83±0.18)×10-3mm2/s,明显高于增生结节(1.17±0.24mm2/s)(t值为0.4 60,P=0.00).多期DCE,前列腺癌的最大信号强度为385.60±108.27,增生结节的最大信号强度为393.21±111.28(t值为-0.270,P=0.788),两者比较没有显著性差异.前列腺癌时间信号强度曲线以速升速降为主,而增生结节以渐进型和速升平台型为主,两者具有显著性差异(P=0.00);其中速升速降型和渐进型曲线于组间具有显著性差异).结论:前列腺中央叶T2WI低信号结节中,前列腺癌与前列腺增生于T2 WI边缘和信号均匀性、DWI的信号强度和ADC值、曲线类型均有差异.故MRI多序列成像分析助于对中央腺体T2WI低信号结节良恶性的鉴别诊断.

The MRI analysis of benign and malignant low signal nodes on T2 WI in the central gland of prostate

Objective:To explore MRI manifestations of benign and malignant low signal nodes on T2WI in the central gland of prostate to improve the ability of differential diagnosis.Methods:19 patients with prostate careinomas and 61 with prostate hyperplasia in accordance with inclusion criteria confirmed by histopathology underwent multi-sequences MRI scans.The signal intensity and margin on T2WI,signal intensity and ADC value on DWI,maximal signal intensity and type of time signal intensity curve were compared between prostate carcinomas and hyperplasia.Results:19 prostate carcinomas on T2WI showed that margins of nodes were unclear in 16 cases and clear in 3 cases with homogeneous low signal intensity.61 prostate hyperplasia nodes on T2WI showed that the margins were unclear in 34 cases,clear in 27 cases and the signal of 30 nodes were homogeneous,of 31 nodes were inhomogeneous.There was statistical significance in T2 WI manifestations (P =0.007) between carcinoma and hyperplasia.On DWI (b=1000s/mm2),signal intensity of prostate carcinomas was 60.6 ± 10.7 which was higher than that of hyperplasia nodes (49.7 ± 8.5)(t=-5.793,P=0.00).ADC value of prostate carcinomas was (0.83±0.18)×10-3mm2/s,which was lower than that of hyperplasia nodes (1.17±0.24mm2/s)(t 0.460,P 0.00).In multi phase DCE,maximal signal intensity of prostate carcinomas was 385.60 ± 108.27,and that of hyperplasia nodes was 393.21 ± 111.28 (t=-0.270,P=0.788).There was no significant difference between prostate carcinomas and hyperplasia.The time-signal intensity curve types of prostate carcinomas were mainly rapid rising and rapid dropping,curve types of hyperplasia nodes were mainly rapid rising-plateau and gradual rising.There was statistical difference in signal intensity curve types between carcinoma and hyperplasia (P=0.00).especially in rapid rising rapid dropping and gradual rising curve types.Conclusion:In low signal nodes on T2 WI in central gland of prostate,the margin and signal homogeneity on T2 WI,signal intensity and ADC values on DWI,the time-signal intensity curve types were different between prostate careinomas nodes and hyperplasia nodes.So MRI multi-sequences imaging was helpful for differential diagnosis between benign and malignant low signal nodes on T2WI in the central gland of prostate.