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目的评价前列腺MRI三维(3D)立体重组在前列腺癌诊断和治疗中的作用。方法28例前列腺癌患者,年龄54～76岁,平均66．3岁。根据穿刺活检结果,14例为外周带癌,3例为中央腺体癌,另外11例患者为前列腺癌治疗后复查患者,其中9例采用内分泌治疗,2例采用放射性粒子置入治疗。所有患者均行直肠内线圈的轴面T2WI序列扫描,所得图像经3D-Doctor软件处理后得到3D重组立体图像。结果14例前列腺外周带癌患者的3D重组立体图像中,有4例显示癌区局限于外周带内,占位效应不明显,外周带形态未见变化;其余10例癌组织向外周带外生长,造成局部外周带增厚,包膜外凸。3例中央腺体癌患者3D图像表现为受累中央腺体体积增大,压迫相邻外周带。2例放射性粒子置入患者可以清楚地显示出放射性粒子在前列腺内的空间分布情况;9例内分泌治疗后患者可见前列腺整体和癌区的体积缩小,包膜外凸减轻。结论3D重组图像可以显示出前列腺外周带、中央腺体和癌区的立体位置关系,为穿刺活检提供了更直观的信息。前列腺MRI三维立体重组在前列腺癌诊断和治疗中可以发挥一定的辅助作用。
Objective To evaluate the role of prostate three dimensional (3D) stereological recombination in the diagnosis and treatment of prostate cancer. Methods 28 cases of prostate cancer patients, aged 54 to 76 years, mean 66.3 years. According to the results of biopsy, 14 cases had peripheral cancer, 3 cases had central gland cancer, and 11 cases were diagnosed after prostate cancer treatment. Among them, 9 cases were treated with endocrine therapy and 2 cases were treated with radioactive particle implantation. All patients underwent axial T2WI sequence scan of the rectum coil. The obtained images were processed by 3D-Doctor software to obtain 3D recombinant stereoscopic images. Results Of the 14 patients with peripheral prostate cancer with prostate cancer, 4 of them showed that the cancer area was confined to the peripheral zone with no obvious effect of space-occupying effect and no change in the shape of the peripheral zone. The remaining 10 cancer tissues were out-of-band , Resulting in local peripheral zone thickening, convex envelope. 3 cases of central gland cancer patients showed 3D images of the affected central gland volume increases, oppression adjacent peripheral zone. Two cases of radioactive particles into the patient can clearly show the spatial distribution of radioactive particles in the prostate; 9 cases of endocrine therapy can be seen in the prostate and cancer area of the overall volume reduction, capsule convex relief. Conclusion The 3D reconstruction images can show the three-dimensional positional relationship between the peripheral zone of the prostate, the central gland and the cancer area, and provide more intuitive information for the biopsy. Prostate MRI three-dimensional recombinant prostate cancer diagnosis and treatment can play a supporting role.