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目的探讨扩散加权成像(DWI)与超声检查对前列腺特异性抗原(PSA)(4~10μg/L)患者前列腺癌(PCA)的诊断价值。方法收集2014年1月至2015年9月我院62例前列腺疾病患者,均行超声、常规磁共振及DWI检查,所有患者PSA均为4~10μg/L,分析DWI和表观扩散系数(ADC)图,测量感兴趣区ADC值,根据病理结果对DWI与超声诊断PCA的准确率进行分析。结果经病理证实PCA 32例,前列腺增生(BPH)30例,DWI、超声诊断PCA准确率分别为93.8%、50.0%。PCA癌灶在DWI呈明显高信号,ADC则为低信号。增生结节分为腺体增生与肌纤维增生,DWI与ADC图上信号各异。前者DWI为不均匀高信号,ADC图上呈稍高信号;后者DWI图上为低信号,ADC图上呈稍低信号。b=800 s/mm2时PCA灶、BPH外周带、腺体增生、肌纤维增生ADC值分别为(0.76±0.08)×10-3mm2/s、(2.04±0.22)×10-3mm2/s、(1.78±0.19)×10-3mm2/s、(1.43±0.13)×10-3mm2/s,四者之间比较差异有统计学意义(P<0.05)。结论 PCA、腺体增生与肌纤维增生在DWI及ADC上信号与ADC值差别较大。DWI能提高PSA(4~10μg/L)内PCA诊断准确率,对鉴别PCA和BPH有重要意义,明显弥补常规磁共振及超声检查的不足。
Objective To investigate the diagnostic value of diffusion weighted imaging (DWI) and ultrasonography in the diagnosis of prostate cancer (PCA) in patients with prostate specific antigen (PSA) (4 ~ 10μg / L). Methods Sixty-two patients with prostatic diseases in our hospital from January 2014 to September 2015 were enrolled in this study. All patients underwent ultrasound, routine MRI and DWI. The PSA of all patients was 4 ~ 10μg / L. The DWI and ADC ), The ADC value of the region of interest was measured, and the accuracy of DWI and PCA was analyzed according to the pathological results. Results 32 cases of PCA confirmed by pathology, 30 cases of benign prostatic hyperplasia (BPH), and 93.8% and 50.0% of diagnostic accuracy of PCA by DWI and ultrasound. PCA foci in DWI was significantly higher signal, ADC was low signal. Hyperplasia of nodules is divided into glandular hyperplasia and myofibrillar hyperplasia, DWI and ADC signal on the map different. The former DWI is a non-uniform high signal, slightly higher signal on the ADC graph; the latter is a low signal on the DWI graph and a slightly lower signal on the ADC graph. The ADC values of PCA foci, BPH peripheral zone, glandular hyperplasia and myofibrillar hyperplasia were (0.76 ± 0.08) × 10-3mm2 / s, (2.04 ± 0.22) × 10-3mm2 / s and ± 0.19) × 10-3mm2 / s and (1.43 ± 0.13) × 10-3mm2 / s, respectively, with significant difference between the four groups (P <0.05). Conclusions PCA, glandular hyperplasia and myofibrillar hyperplasia have different signal and ADC values on DWI and ADC. DWI can improve the diagnostic accuracy of PCA in PSA (4 ~ 10μg / L), which is of great significance in differentiating PCA and BPH, and obviously makes up for the deficiencies of conventional magnetic resonance and ultrasonography.