赵汝莲+高娜

[摘要] 目的 探讨MRI对前列腺癌及前列腺增生的诊断价值，旨在提高前列腺疾病的诊断准确性并进行鉴别诊断。方法 回顾性总结分析我院2015年1月～2017年1月经病理和随访证实的前列腺病变患者60例，均有完整的MRI及临床资料，其中良性前列腺增生52例，前列腺癌8例。 结果 52例BPH患者中，增生的前列腺结节在T1加权像上呈均匀稍低信号，T2加权像上呈高、低相间的混杂信号，在增生的结节周围常可见一环形低信号假包膜。8 例PCa患者中，3例横断面T2WI上外周带内可见低信号，2例前列腺形态规则，表面光整；1例形态不规则，表面不光整，边缘模糊，外周带信号一致性减低，与中央区分界不清；其中1例累及精囊腺；骨转移1例。其中局限于一侧的单发病灶为6例，双侧同时累及并弥漫多发的病灶為2例；MRI诊断前列腺癌的诊断符合率87.5%、诊断前列腺增生的诊断符合率92.3%。 结论 MRI用于前列腺癌及前列腺增生的诊断有利于提高疾病诊断的准确性，具有重要的临床应用价值。

[关键词] 前列腺癌；前列腺增生；MRI；诊断价值

[中图分类号] R737.25；R697.3；R445 [文献标识码] B [文章编号] 1673-9701（2017）25-0105-03

Analysis on the diagnostic value of MRI in prostate cancer and benign prostatic hyperplasia

ZHAO Rulian GAO Na

CT/MR Room， Changle County Peoples Hospital in Shandong Province， Changle 262400， China

[Abstract] Objective To investigate the diagnostic value of MRI in the diagnosis of prostate cancer and benign prostatic hyperplasia， in a bid to improve the diagnostic accuracy of prostate disease and to differentiate the diagnosis. Methods 60 patients with prostate lesions who were confirmed by pathology and follow-up visit from January 2015 to January 2017 in our hospital were analyzed retrospectively. They all had complete MRI and clinical data. Among them， there were 52 cases of benign prostatic hyperplasia， and 8 cases of prostate cancer. Results Of the 52 patients with BPH， the proliferative prostatic nodules showed a slightly lower even signal on T1-weighted images， and showed high and low inter-mixed signals on T2-weighted images. A pseudocapsule with a low circular signal could be seen around the hyperplastic nodules. Among the 8 patients of PCa， low signals could be detected in the peripheral band on cross-section T2WI in 3 cases. 2 cases were with regular prostate morphology， and smooth surface； 1 case was with irregular shape， unsmooth surface and ambiguous edge. The signal consistency of the peripheral band was reduced， and the boundary with the central area was unclear； seminal vesicle was involved in 1 case； and bone metastasis was detected in 1 case. There were 6 cases of single lesions limited to one side， and there were 2 cases of multiple diffuse lesions with simultaneous involvement in both sides； the accordance rate of MRI diagnosis of prostate cancer was 87.5%， and the accordance rate of the diagnosis of benign prostatic hyperplasia was 92.3%. Conclusion MRI is an important diagnostic value for prostate cancer and benign prostatic hyperplasia， which is helpful to improve the diagnostic accuracy of prostate disease.endprint

[Key words] Prostate cancer； Prostatic hyperplasia； MRI； Diagnostic value

前列腺增生（benign prostate hyperplasia，BPH）、前列腺癌（prostate carcinoma，PCa）均是常见的前列腺疾病，近年来发病率逐年增多，且研究发现，前列腺增生易合并前列腺癌[1-2]。前列腺增生和前列腺癌二者影像学表现常有交错重叠，诊断与鉴别诊断难度较大。且前列腺癌是老年男性常见的恶性肿瘤之一，预后较差，其治疗及预后主要取决于早期诊断与术前分期[3-4]。磁共振成像（megnetic resonance imaging，MRI）技术组织分辨率高，无创伤，无辐射，且可多方位成像，在前列腺疾病的诊断中应用越来越广泛[5]。……