龙小武+庄伟雄+黄文飞+冯渭昌

[摘要] 目的 探讨磁共振扩散加权成像（DWI）对前列腺癌侵犯膀胱内分泌治疗效果的评估价值。 方法 25例经病理证实的前列腺癌侵犯膀胱患者，经3～12个月的内分泌治疗前后分别进行1.5T磁共振常规检查及DWI检查，分析前列腺癌、受侵膀胱壁、正常膀胱壁的DWI图像，比较ADC值。 结果 治疗前，前列腺癌、受侵膀胱壁的DWI（b=800 s/mm2）呈高信号，ADC呈低信号，正常膀胱壁呈等信号。前列腺癌、受侵膀胱壁及正常膀胱壁的ADC平均值分别为（0.85±0.12）×10-3 mm2/s、（0.91±0.15）×10-3 mm2/s、（1.32±0.11）×10-3 mm2/s；治疗后，前列腺癌、受侵膀胱壁的DWI（b=800 s/mm2）信号减低，ADC信号增高，正常膀胱壁信号无变化，前列腺癌、受侵膀胱壁及正常膀胱壁的ADC平均值分别为（1.19±0.18）×10-3 mm2/s、（1.21±0.13）×10-3 mm2/s、（1.28±0.17）×10-3 mm2/s。前列腺癌、受侵膀胱壁治疗前后的ADC平均值比较差异有统计学意义（P＜0.05）；正常膀胱壁治疗前后ADC平均值比较差异无统计学意义（P＞0.05）。 结论 DWI是评估前列腺癌侵犯膀胱内分泌治疗效果的有效方法。

[关键词] 前列腺癌；膀胱；内分泌治疗；磁共振成像；扩散加权成像

[中图分类号] R81[文献标识码] A[文章编号] 1674-4721（2014）04（c）-0106-03

Evaluation analysis of MR diffusion-weighted imaging on endocrine treatment effect in prostate carcinoma invading bladder

LONG Xiao-wu ZHUANG Wei-xiong HUANG Wen-fei FENG Wei-chang

Department of Radiology,People′s Hospital of Yunfu City in Guangdong Province,Yunfu527300,China

[Abstract] Objective To discuss evaluation value of MR diffusion-weighted imaging(DWI)on endocrine treatment effect in prostate carcinoma invading bladder. Methods 25 cases of patients with prostate carcinoma invading bladder were confirmed by pathology and examined by convensional MRI and DWI at 1.5T unit before and after 3 to 12 months endocrine treatment.DWI appearance of prostate carcinoma,bladder invasion and normal bladder wall was analyzed respectively,ADC value was compared. Results Before treatment,prostate carcinoma and bladder invasion showed markedly high-signal on DWI(b=800 s/mm2)and low-signal on ADC map,normal bladder wall showed intermediate-signal.The average ADC value in prostate carcinoma,bladder invasion and normal bladder wall region was(0.85±0.12)×10-3 mm2/s,(0.91±0.15)×10-3 mm2/s,(1.32±0.11)×10-3 mm2/s respectively.After treatment,prostate carcinoma and bladder invasion showed signal be lowered on DWI(b=800 s/mm2)and be raised on ADC,and not significantly change in normal bladder wall.The average ADC value in prostate carcinoma,bladder invasion and normal bladder wall region was(1.19±0.18)×10-3 mm2/s,(1.21±0.13)×10-3 mm2/s,(1.28±0.17)×10-3 mm2/s respectively.The ADC value of prostate carcinoma and bladder invasion was compared respectively,with statistical difference(P＜0.05).The ADC value of normal bladder wall was compared,with no statistical difference(P＞0.05). Conclusion DWI is an effective method for assessment of endocrine therapy in prostate carcinoma invading bladder.

[Key words] Prostate carcinoma;Bladder;Endocrine therapy;Magnetic resonance imaging;Diffusion-weighted imaging

前列腺癌是老年男性常见的恶性肿瘤之一，在美国65岁以上的男性发病率已高于肺癌[1]；随着我国人口老龄化，前列腺癌发病率呈升高趋势。近年来随着磁共振（MR）的普及使用，尤其是MR功能成像快速发展，磁共振成像（MRI）是目前诊断前列腺疾病的最佳影像检查方法。内分泌治疗是晚期（C、D期）前列腺癌的主要治疗方法，包括去势疗法、雄激素疗法、雌激素疗法。笔者通过应用1.5T MR扩散加权成像（diffusion-weighted imaging，DWI）技术检查25例前列腺癌侵犯膀胱患者，分析前列腺癌及受侵膀胱壁在内分泌治疗前后的DWI图像及ADC值的变化，评估内分泌治疗的效果。……