目的 分析比较高场MRI平扫和多 组b值DWI技术对前列腺癌的诊断价值。 方法 回顾性分析2012年5月至2017年5月 期间收治的50例前列腺癌患者和50例良 性前列腺病变患者的临床资料，所有患 者经手术或穿刺活检后经病理证实，均 行高场MRI平扫及DWI扫描，DWI扫描采用 横轴位平面回波成像(ERPI)序列，弥散 敏感系数(b)值选取较高值1000、2000、 3000s/mm2 。分析高场MRI平扫、不同b值 DWI对鉴别诊断前列腺癌、良性病变的效 能。结果 高场MRI平扫显示前列腺癌病灶 可位于外周带、中央腺体，病灶形态不规 则，边界不清晰，多数突破包膜，可见侵 犯周围组织及发生骨转移，其诊断前列腺 癌的敏感度为76.00%、特异度为71.70%、 准确度为72.00%。b=1000s/mm2 时，病灶 在DWI图上表现为稍高信号，随着b值升高 (2000、3000s/mm2 )，病灶区的信号与正 常组织对比更加明显，转移淋巴结、骨 转移病灶在DWI图上表现为弥散受限高信 号，而良性病变即使在较高的b值上信号 仍不高，且显示不清；b=1000，2000， 3000s/mm2 时，DWI对诊断前列腺癌的敏感 度为80.67%、89.80%、94.00%，特异度 为64.52%、73.77%、94.00%，准确度为 79.00%、88.00%、94.00%，即b值越高， DWI对前列腺癌的诊断效能越高。结论 与 高场MRI平扫相比，应用多组b值DWI技术 具有前列腺癌更高的诊断效能，更有助于 前列腺癌的早期诊断与临床治疗。

Objective To analyze and compare the diagnostic value of high-field MRI plain scan and multiple sets of b-value DWI in prostate cancer. Methods The clinical data of 50 cases of prostate cancer and 50 cases of benign prostatitis from May 2012 to May 2017 were retrospectively selected. All the patients were treated with high-field MRI plain scan and DWI scan, and the DWI scan was performed with transverse axial plane echo imaging (ERPI) sequence, and the diffusion sensitivity coefficient (b) was chosen to be a high value of 1000, 2000, 3000 s/mm2 . The efficacy of high-field MRI scan and different b-value DWI in differential diagnosis of prostate cancer and benign lesions was analyzed. Results High-field MRI scan showed that prostate cancer lesions could be located in the peripheral zone and the central glands with irregular lesions, unclear border and most breakthrough capsule, showing the surrounding tissue and bone metastases. And the sensitivity was 76.00%, the specificity was 71.70% and the accuracy was 72.00% in the diagnosis of prostate cancer. When b=1000s/mm2 , the lesion showed a slightly higher signal on the DWI map. And with the increase of b value(2000, 3000s/mm2 ), the low signal of the lesion area was more obvious than that of the normal tissue, and the metastatic lymph node and the bone metastatic lesions were shown diffuse high signal in DWI images while the benign lesions were shown not high signal and unclear display even in the higher b value. When b=1000, 2000, 3000 s/mm2 , the sensitivity of DWI in diagnosing prostate cancer was 80.67%, 89.80%, 94.00%, and the specificity was 64.52%, 73.77%, 94.00% and the accuracy was 79.00%, 88.00% and 94.00%. That is, the higher the b-value, the higher the diagnostic efficacy of DWI for prostate cancer. Conclusion Compared with the high field MRI plain scan, the application of multiple sets of b-value DWI technology has a higher diagnostic efficacy of prostate cancer and contributes to the early diagnosis and clinical treatment of prostate cancer.