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磁共振功能成像诊断中央区前列腺癌的临床应用价值探讨
马寅锋1, 吕伯东, 黄晓军, 胡青, 张志田2
1.浙江中医药大学附属第二医院泌尿外科、国家临床重点专科、浙江省重点学科、浙江省中医药重点实验室;2.放射科
摘要:
目的探讨磁共振功能成像(fMRI)在中央区前列腺癌诊断中的应用价值。方法回顾性分析20例经临床、病理检查证实为中央区前列腺癌患者的术前MRI图像,包括T2WI、动态对比增强MRI(DCE-MRI)、扩散加权成像(DWI)及表观扩散系数(ADC),从而得到中央区前列腺癌的影像特征,计算fMRI在中央区前列腺癌检测中的准确率。结果20例患者前列腺中央区显示完整,fMRI共提示恶性病灶26个,24个与临床病理诊断相符合,其中9个病灶与外周带界限不清,另外2个病灶与病理诊断不符合。1例患者病理检查提示侵犯外周带而MRI显示不明显。MRI功能成脉对中央区前列腺癌诊断准确率92.31%。结论fMRI能显示前列腺中央区,并能对中央区前列腺癌作出较为准确的诊断,为临床治疗方案的选择提供理论依据。
关键词:  前列腺癌 磁共振成像扩散加权像 表观扩散系数 动态增强
DOI:
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基金项目:浙江省中医药管理局课题
Magnetic resonance imaging in diagnosis of prostate cancer in central zone
MA Yanfeng,LV Bodong,HUANG Xiaojun,HU Qing,ZHANG Zhitian
the Second Affiliated Hospital of Zhejiang Chinese Medical University
Abstract:
Objective To evaluate the application of functional magnetic resonance imaging (fMRI) in the diagnosis of prostate cancer in the central zone. Methods Twenty patients with prostate cancer in the central zone confirmed by pathological examination underwent MRI examination. The clinicopathological features and MRI results, including T2WI, DCE-MRI, diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) were retrospectively analyzed. Results Complete prostate center were showed on MRI in all 20 patients, and 26 nodules were diagnosed as malignant, among which 24 nodules were consistent with the pathological findings. Nine nodules had obscure peripheral boundaries, which were in accordance with pathology; and one case with pathological invasion of peripheral zone was not showed on MRI. Conclusion fMRI can completely display the central zone of prostate and make comparatively accurate diagnosis of prostate cancer.
Key words:  Prostate cancer Magnetic resonance imaging diffusion weighted imaging Apparent diffusion coefficient Dynamic enhancement MRI