DWI在正常前列腺及前列腺疾病的初步应用

目的研究正常前列腺、前列腺癌(PCa)、良性前列腺增生(BPH)和前列腺囊肿的DWI表现及其ADC值的变化特点,探讨DWI在前列腺疾病诊断和鉴别诊断的应用。方法分别对16名健康志愿者,9例前列腺囊肿,29例BPH和21例PCa患者进行前列腺DWI扫描,分析正常前列腺中央带、外周带、囊肿、前列腺增生结节以及前列腺癌灶的DWI表现、ADC值的变化特点及其在诊断和鉴别诊断的价值。所有BPH和PCa病例均经病理证实。结果DWI表现:16名志愿者外周带信号高于中央带,二者分界清晰;囊肿呈高信号;BPH增生结节信号不均匀,信号强度低于外周带;PCa表现为低信号影。各组平均ADC值:正常前列腺中央带(1.352±0.052)×10-3mm2/s,外周带(1.829±0.071)×10-3mm2/s,囊肿(2.557±0.084)×10-3mm2/s,BPH增生结节(1.576±0.101)×10-3mm2/s,PCa癌灶(0.934±0.166)×10-3mm2/s,其ADC值由高到低依次为前列腺囊肿、正常外周带、BPH、正常中央带和PCa癌灶(P=0.000)。结论DWI及ADC值在一定程度上有助于正常前列腺、前列腺囊肿、BPH和PCa之间的鉴别。

Diffusion-weighted imaging in normal prostate and differential diagnosis of prostatic diseases

Objective To investigate the DWI appearance and the ADC value of the normal prostate gland, cyst of prostate, benign prostatic hyperplasia (BPH) and prostatic carcinoma (PCa), and to evaluate the value of DWI in the diagnosis and differential diagnosis of prostatic diseases. Methods Sixteen healthy volunteers, 9 prostate cysts, 29 BPH and 21 PCa were scanned with DWI respectively. Their DWI and ADC characteristics were analyzed and the diagnositic and differential diagnositic values of DWI and ADC were summarized. All the BPH and PCa received a histological diagnosis. Results DWI appearance: the central zone and peripheral zone of normal prostate were shown clearly. The signal intensity of BPH nodule was nonuniform and lower than the peripheral zone. PCa showed very low signal intensity while the prostate cyst showed high signal intensity. The mean ADCs for the normal central gland, peripheral zone, cyst of prostate, BPH nodules and PCa focus were (1.352±0.052)×10^-3 mm²/s, (1.829±0.071)×10^-3 mm²/s, (2.557±0.084)×10^-3 mm²/s, (1.576±0.101)×10^-3 mm²/s and (0.934±0.166)×10^-3 mm²/s respectively (P=0.000). Conclusion The DWI appearance and ADCs for the normal central gland, peripheral zone, cyst of prostate, BPH nodules and PCa demonstrate a significant difference, and that can be used in the diagnosis and differential diagnosis of the diseases of prostate.