目的 探究MRI平扫联合应用 DWI、MRS、DCE-MRI对前列腺病变的诊断 价值。方法 对47-85岁中老年男性153例 行常规磁共振检查，其中正常前列腺病人 联合弥散加权像、波谱分析，疑诊前列腺 癌和增生病人联合DWI、MRS及DCE-MRI检 查，后行DWI和MRS分析，绘制DCE-MRI感 兴趣区时间-信号曲线。统计分析正常前 列腺生物学行为、代谢产物特征，前列腺 癌和前列腺增生两种病变生物学行为、代 谢产物胆碱(Cho)、枸橼酸盐(Cit）、肌 酸(Cre)的峰值特征及(Cho＋Cre)/Cit均 值的比较，以及动态增强分析增生和癌 变血液动力学特征，用独立样本t检验， P＜0.05认为差异具有统计学意义。最后 MRI诊断为前列腺增生和前列腺癌的病例 进行穿刺或电切活检比较两者的符合率。 结果 30例正常前列腺中央区T1WI呈等或 稍高信号、外周带T1WI呈均匀中等或略偏 低信号，T2WI中央区呈中等信号，外周 带呈新月形高信号，DWI正常前列腺中央 区、外周带信号无显著差异。正常前列腺 中央腺区、前列腺增生、前列腺癌之间 ADC值差异有统计学意义(P<0.05)，正常 前列腺外周带与前列腺增生之间ADC值差 异无统计学意义(P>0.05)。正常前列腺外 周带与增生病变代谢产物峰值比无显著差 异(P>0.05)，前列腺增生与前列腺癌代谢 产物峰值比值具有显著差异(P＜0.05)。 结论 MRI平扫T2WI对前列腺病变显示敏感 性高、特异性低，DCE-MRI、DWI和MRS三 种检查方法在前列腺癌诊断中具各具有特 征性表现, 平扫联合功能成像DWI、MRS、 DCE-MRI可较大程度提高病变诊断的敏感 性、特异性甚至定量诊断。

Objective Application of magnetic resonance imaging (MRI) scan in combination with a variety of functional imaging of normal prostate, prostate cancer and prostate hyperplasia patients for biological behaviour, metabolic product characteristics and dynamic enhancement time-signal curve for this paper. Methods Selected age 47-85, 153 cases of elderly men patients in the conventional magnetic resonance imaging. Normal prostate patients combined diffusion weighted image can, 3D1H-MR spectroscopy, Suspected diagnosis of patients with hyperplasia of prostate and joint DWI, MRS and DCE-MRI, DWI and MRS can after analysis, Draw the DCE-MRI mearn curve areas of interest. Statistical analysis of normal prostate biological behavior characteristics, metabolites, Hyperplasia of prostate and prostate two lesions choline (Cho)biological behaviour, metabolites,citrate salt(Cit), characteristics of creatine(Cre) and peak(Cho+Cre)/ Cit the comparison of the mean, Dynamic enhanced nodule hemodynamic characteristics analysis of hyperplastic nodule and cancer,With independent samples t test, P<0.05 think the difference is statistically significant.The MRI diagnosis of prostatic hyperplasia and prostate cancer cases biopsy or cutting biopsy compared the coincidence rate. Results 30 cases of normal prostate central T1WI, or slightly high signal, the peripheral zone T1WI homogeneously middle or slightly low signal,T2WI central moderate signals, Peripheral zone crescent high signal, DWI normal central and peripheral zone of prostate can signal no significant difference. Normal prostate central, prostate hyperplasia, prostate gland area between ADC values difference was statistically significant(P<0.05),Normal prostate peripheral zone and ADC values differences between prostatic hyperplasia has no statistical significance (P>0.05). The hyperplasia and normal prostate peripheral zone lesions metabolites peak than there was no significant difference (P>0.05), prostatic hyperplasia and prostate cancer metabolites peak ratio has significant difference (P<0.05). Conclusion MRI scan T2WI of prostate lesions showed low sensitivity, high specificity, DCE- MRI, DWI and MRS can three inspection methods in the diagnosis of prostate cancer with the characteristic, joint function imaging DWI, MRS, DCE can scan, MRI can largely improve lesions diagnostic sensitivity, specificity, and even the quantitative diagnosis.