目的回顾性分析T2WI结合DWI预 测评估前列腺癌患者包膜外扩散，同时比 较有或无包膜外扩散前列腺癌ADC值。方 法 76例前列腺癌患者在前列腺切除术前 执行3.0T磁共振检查。由2名经验丰富放 射医师分析T2WI和T2WI结合DWI图像，评 估外周叶包膜外扩散情况，对有或无包膜 外扩散进行ADC值，比较2患者结果。结果 共研究456区，其中74个区有包膜外扩散 情况，T2WI和T2WI结合DWI特异性和敏感 性分别为94.5%、91.7%，优于T2EWI单独 检查(分别为87.2%、81.2%)，p<0.001。 采用ROC分析显示T2WI结合DWI曲线下面 积(Az=0.900)明显大于T2WI曲线下面积 (Az=0.828)，p<0.001。包膜外扩散ADC值 明显低于无包膜外扩散ADC值(p<0.001)。 结论 T2WI结合DWI图像能够提高预测前列 腺癌患者包膜外扩散情况，同时ADC值在 评估有或无包膜外扩散具有重要意义。

Objective To retrospectively investigate combine diffusion-weighted imaging (DWI) and T2-weighted imaging for the prediction of extracapsular extension (ECE) in patients with prostate cancer, as well as to compare apparent diffusion coefficients (ADCs) between patients with and without ECE. Methods Seventy-six patients underwent 3T magnetic resonance imaging (MRI) before prostatectomy. Two experienced radiologists analyzed T2-weighted images alone and in combination with DWI in consensus and rated the likelihood of ECE. Tumor ADC values were measured, and the results were compared between patients with and without ECE. Results Of the 456 sectors studied, 74 (16%) were positive for ECE in 31 patients. the specificity and accuracy of combined T2-weighted imaging and DWI were 94.5% and 91.7%, respectively, superior to T2- weighted imaging alone (87.2% and 81.2%, respectively) (p<0.001). On receiver operating characteristic analysis, the area under the curve (Az) of combined T2-weighted imaging and DWI (Az=0.900) was significantly greater than that of T2-weighted imaging alone (Az=0.828) (p<0.001). The mean tumor ADC values were significantly lower in patients with ECE than patients without ECE (p<0.001). Conclusion DWI in addition to T2- weighted imaging improves the ability to predict ECE in patients with prostate cancer. Furthermore, tumor ADC values in patients with and without ECE are significance.