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1.5T MR多序列对前 列腺增生与前列腺 癌诊断价值

作者:刘 勇1 张刘璐1 江 澜1 宋震宇1 陈正君2

所属单位:1.西南医科大学附属中医医院磁共 振室 (四川 泸州 646000) 2.西南医科大学附院 (四川 泸州 646000)

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摘要

目的 探究飞利浦Intera 1.5T MR多序列对前列腺增生与前列腺癌的诊断 价值,筛选最佳序列组合应用于临床。方 法 对收集的187例前列腺增生患者、86例 前列腺癌患者行飞利浦Intera 1.5T MR检 查。选用序列有常规序列(T1WI/T2WI)、 脂肪抑制(SPAIR)、弥散成像(DWI)、单 体素波谱成像(MRS),52例前列腺癌加扫 全身弥散成像(WB-DWI)。对比分析常规序 列、常规序列+SPAIR、常规序列+DWI、常 规序列+SPAIR+DWI、常规序列+DWI+MRS的 应用价值以及WB-DWI对前列腺癌骨转移 的筛查价值。结果 BPH组:常规序列、 常规序列+SPAIR、常规序列+SPAIR+DWI 诊断准确率高(100%)。PCa组:常规序列 +SPAIR+DWI、常规序列+DWI+MRS 诊断准 确率分别为94%和95%,高于其他序列组 合。WB-DWI对前列腺癌骨转移检出率高。 结论 常规序列能够诊断前列腺增生,常 规序列+DWI+MRS对前列腺癌诊断准确率更 高,WB-DWI是无辐射污染、重复性好、检 查步骤不繁琐、一站式筛查全身转移病变 的最好序列。

Objective To Investigate the value of Philips Intera 1.5T MR multiple sequences in diagnosis of benign prostatic hyperplasia(BPH) and prostate cancer(PCa), search the best sequence combination for clinical application. Methods Collected 187 cases of benign prostatic hyperplasia(BPH group), 86 cases of prostate cancer(PCa group), all cases undertake Philips Intera 1.5T MR scan. Scan sequence: conventional sequences(T1WI/T2WI), spectral presaturation attenuated inversion recovery (SPAIR), diffusion weighted imaging(DWI), MR-spectroscopy(MRS).52 cases of PCa add whole body diffusion weighted imaging scan(WB-DWI). Compared and analyzed the application value of conventional sequences, conventional sequences+SPAIR, conventional sequences+DWI, conventional sequences+SPAIR+DWI, conventional sequences+DWI+MRS and the detective value of WB-DWI in bone metastasis of prostate cancer. Results BPH group: Conventional sequences, conventional sequences+ SPAIR, conventional sequences+SPAIR+DWI, the three scanning modes have the highest diagnostic accuracy(100%). PCa group: the diagnostic accuracy rate of conventional sequences+SPAIR+DWI(94%) and conventional sequences+DWI+MRS(95%) are higher than other sequences. WB-DWI has high detection rate in bone metastasis of prostate cancer. Conclusion Conventional sequence can diagnose BPH; conventional sequence+DWI+MRS has higher diagnostic accuracy rate in PCa; WB-DWI is the best sequence in detective bone metastasis of prostate cancer with advantages of no radiation pollution, better repeatability and one-stop body screening.

【关键词】前列腺;增生;癌;序列; 组合;磁共振成像

【中图分类号】R737.25;R697+.32

【文献标识码】A

【DOI】10.3969/j.issn.1672- 5131.2017.08.031

前言

前列腺癌与前列腺增生是泌尿生殖系统的常见病和多发病,严重 威胁着中老年男性的健康。诊断疾病除穿刺活检与病理检查为金标准 外,影像检查仍然为主要的辅助诊断手段。MRI是目前软组织分辨率最 高的检查方法,能够在前列腺疾病没有导致前列腺形态改变、仅有内 部信号异常时发现病灶。因其多序列成像特点,选择适合序列组合, 更利于前列腺疾病的筛查与诊断[1]。本文对BPH 187例、PCa 86例扫描 序列分析,探究最佳序列组合应用于临床。