目的 探讨磁共振(MR)扩散加 权成像(DWI)诊断前列腺癌的临床价 值。方法 选取2012年2月至2014年12月 我院收治的前列腺癌患者临床资料90 份为研究样本，术前1个月内均行常规 磁共振扫描(T2WI)及DWI，记录T2WI、 DWI、(T2WI+DWI)三种诊断方法的表观 扩散系数值(ADC)，同将诊断结果与组 织病理结果对照，比较三种诊断方法的 敏感度、特异度及准确度，并分析ADC 值与前列腺癌Gleason分级、TNM分期的 相关性。结果 早期前列腺癌患者ADC值 [(0.85±0.17)×10-3mm2 /s]低于良性前列 腺增生及前列腺炎患者，但组间比较无 统计学意义(P>0.05)，随TNM分期增加， 前列腺癌患者ADC值降低，各期差异无统 计学意义(P>0.05)。T2WI、DWI、T2WI＋ DWI三种诊断方法对早期前列腺癌的诊断 灵敏度分别为66.7％、83.3％、90.0％， 特异度分别为76.7％、75.0％、80.0％， 准确度分别为73.3％、77.8％、83.3％， 其中T2WI＋DWI诊断的灵敏度明显高于 T2WI(P<0.05)，三种诊断方法特异度及准 确度比较无显著差异(P>0.05)；相关分析 显示前列腺癌区ADC值与Gleason分级呈负 相关(r=-0.576，P<0.05)，与TNM分期无 相关性(r=-0.234，P>0.05)。结论 磁共 振扩散加权成像对前列腺癌的诊断及临床 病情评估具有较高的参考价值，值得在临 床推广应用。

bjective To explore clinical value of magnetic resonance (MR) diffusion weighted imaging (DWI) in the diagnosis of prostate cancer. Methods 90 cases of clinical data of patients with prostate cancer in our hospital from February 2012 to December 2014 were selected as the research samples, conventional magnetic resonance imaging (T2WI) and DWI were performed 1 month before operation,apparent diffusion coefficient values (ADC) of three diagnostic methods [T2WI, DWI, (T2WI+DWI)] were recorded,diagnosis results were compared with histopathological findings,sensitivity, specificity and accuracy of three diagnostic methods were compared,correlation between ADC values, prostate cancer Gleason grading and TNM staging were analyzed. Results ADC value of patients with early-stage prostate cancer [(0.85±0.17)×10-3mm2 /s] was slightly lower than patients with benign prostatic hyperplasia and prostatitis patients (P>0.05),with the increase of TNM stage, ADC values of prostate cancer patients was reduced, and there was no significant difference in each period (P>0.05). Diagnostic sensitivity to earlystage prostate cancer of three diagnostic methods (T2WI, DWI, T2WI+DWI) were 66.7%, 83.3%, 90.0% respectively, specificity were 76.7%, 75.0%, 80.0% respectively, accuracy were 73.3%, 77.8%, 83.3% respectively, diagnostic sensitivity of T2WI+DWI was significantly higher than T2WI (P<0.05),there was no significant difference in the specificity and accuracy of the three diagnostic methods (P>0.05),correlation analysis showed that ADC values of prostate cancer areas were negatively correlated with Gleason grading (r=-0.576, P<0.05),there was no significant correlation with TNM stage (r=- 0.234, P>0.05). Conclusion Magnetic resonance diffusion weighted imaging has a high reference value for diagnosis of prostate cancer and evaluation of clinical condition,has a value of clinic application.