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目的:探讨动态增强磁共振灌注成像(DCE-MRPI)及定量分析对前列腺良恶性病变的诊断价值。方法:经手术病理证实的35例前列腺癌和23例前列腺增生患者在术前均行常规MRI和DCE-MR灌注成像检查。共采集216个兴趣区的数据,包括前列腺癌结节87处,前列腺增生结节75处,外周带非癌组织54处。在相应的灌注参数图上分别测量各兴趣区的Ktrans和Kep值,并比较三类组织之间的差异,并对其强化曲线类型进行分析。结果:前列腺癌结节、增生结节及外周带非癌组织之间比较,Ktrans和Kep的差异均有统计学意义(χ2=152.54和111.84,P<0.001);前列腺癌结节呈高灌注,外周带非癌组织呈低灌注,增生结节介于两者之间,仅26.7%的增生结节呈高灌注。前列腺癌主要强化方式为速升速降型(62/87)和速生缓降型(24/87);前列腺增生结节的强化方式为速升缓降型(22/75)、速升平台型(20/75)、缓升平台型(22/75)、缓慢上升型(11/75);外周带非癌组织主要强化方式为缓升平台型(37/54)和缓慢上升型(15/54)。结论:磁共振动态增强灌注成像及定量分析在鉴别前列腺良恶性结节中具有较高的临床价值。
Objective: To investigate the diagnostic value of dynamic contrast-enhanced magnetic resonance perfusion imaging (DCE-MRPI) and quantitative analysis in benign and malignant prostatic diseases. Methods: 35 cases of prostate cancer and 23 cases of benign prostatic hyperplasia confirmed by surgery and pathology were examined by routine MRI and DCE-MR perfusion imaging before operation. Totally 216 data of interest areas were collected, including 87 prostate cancer nodules, 75 benign prostatic hyperplasia nodes and 54 non-cancerous tissues in the periphery. The Ktrans and Kep values of each region of interest were measured on the corresponding perfusion parameter maps, and the differences among the three types of tissues were compared. The types of the enhancement curves were also analyzed. Results: There were significant differences between Ktrans and Kep in the nodules of prostate cancer, hyperplastic nodules and peripheral non-cancerous tissues (χ2 = 152.54 and 111.84, P <0.001). Prostate cancer nodules showed high perfusion, Peripheral non-cancerous tissue showed low perfusion, hyperplastic nodules between the two, only 26.7% of hyperplastic nodules were perfusion. The main enhancement methods of prostate cancer were rapid descending type (62/87) and rapid hypothyroidism (24/87). The enhancement modes of benign prostatic hyperplasia were ascending and descending type (22/75), ascending platform type (20/75), ascending platform type (22/75) and slowly rising type (11/75). The main strengthening modes of peripheral non-cancerous tissue were ascending platform type (37/54) and slowly rising type (15 / 54). Conclusion: Dynamic contrast-enhanced MR perfusion imaging and quantitative analysis have high clinical value in differentiating benign and malignant prostatic nodules.