目的 探究动态增强磁共振扫描 (DCE-MRI)鉴别诊断前列腺良恶性病变的 临床价值。方法 回顾性分析行前列腺 MRI、DCE-MRI扫描的72例前列腺疾病患 者的临床资料。所有患者均于MRI扫描后 3个月内行病理穿刺活检，并以此为标准 评估DCE-MRI鉴别诊断前列腺良恶性病变 的敏感性、准确性及特异性。分析病理 确诊良恶性病变患者的DCE-MRI图像特 点，比较其DCE参数[对比剂容积转换常 数(Ktrans)、对比剂回流速率常数(Kep)、 细胞外间隙分数(Ve)、峰值时间(Tmax)、 最大强化程度(SImax)、最大强化率(Rmax)] 差异。结果 病理活检确诊良性前列腺 增生(BPH)45例，前列腺癌(PCa)27例； DCE-MRI鉴别诊断前列腺良恶性病变的敏 感性、特异性及准确性分别为88.89%、 86.67%和87.50%；PCa患者Ktrans、Kep、 SImax、Rmax均高于BPH患者，Tmax则低于BPH 患者(P﹤0.05)；两类患者Ve比较，差异 无统计学意义(P﹥0.05)。结论 BPH和PCa 患者的DCE-MRI扫描图像和常用参数均存 在明显差异，DCE-MRI诊断前列腺良恶性 病变的准确性较高。

Objective To explore the clinical value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differential diagnosis of benign and malignant prostatic lesions. Methods The clinical data of 72 patients with prostate diseases who underwent prostate MRI and DCE-MRI scan were analyzed retrospectively. All patients underwent pathological biopsy at 3 months after MRI scan to evaluate the sensitivity, accuracy and specificity of DCE-MRI in the differential diagnosis of benign and malignant prostatic lesions. The DCE-MRI image features of patients with benign and malignant lesions confirmed by pathology were analyzed. DCE parameters [contrast agent volume transfer constant (Ktrans), contrast reflux rate constant (Kep), extracellular space fraction (Ve), peak time (Tmax), the maximum enhancement degree (SImax), the maximum enhancement ratio (Rmax)] were compared. Results 45 cases of benign prostatic hyperplasia (BPH) and 27 cases of prostate cancer (PCa) were diagnosed by pathological biopsy. The sensitivity, specificity and accuracy of DCE-MRI in the differential diagnosis of benign and malignant prostatic lesions were 88.89%, 86.67% and 87.50% respectively. The Ktrans, Kep, SImax and Rmax were higher in patients with PCa than in patients with BPH, while Tmax was lower than in patients with BPH (P<0.05). However, there was no significant difference in Ve between the two groups (P>0.05). Conclusion There are obvious differences of DCE-MRI scan images and common parameters between patients with BPH and patients with PCa, and the accuracy of DCE-MRI in the diagnosis of benign and malignant prostatic lesions is relatively higher.