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目的:比较n 68Ga-前列腺特异膜抗原(PSMA)PET/CT显像和MRI对中高危前列腺癌术前诊断、分期的价值。n 方法:回顾性分析2018年4月至2019年12月间在华中科技大学同济医学院附属同济医院行n 68Ga-PSMA PET/CT和前列腺MRI检查的中高危前列腺癌术前患者24例[年龄(65.79±7.96)岁]。以病理和随访结果为标准，用n χ2检验比较2种影像手段在中高危前列腺癌术前诊断、分期中的价值。n 结果:24例均经手术病理证实为中高危前列腺癌，Gleason评分：9例7分，15例8～9分；6例精囊侵犯并膀胱颈切缘阳性，5例单精囊侵犯，3例单膀胱颈切缘阳性，10例精囊和膀胱颈切缘均阴性。n 68Ga-PSMA PET/CT显像和MRI对中高危前列腺癌原发灶检出率均为100%(24/24)。n 68Ga-PSMA PET/CT和MRI探测精囊侵犯的灵敏度、特异性和准确性分别为10/11、13/13、95.8%(23/24)和9/11、11/13、83.3%(20/24)，特异性和准确性差异有统计学意义(n χ2值：6.231、13.470，均n P0.05)。n 68Ga-PSMA PET/CT探测前列腺癌盆腔淋巴结转移的灵敏度、特异性和准确性分别为11/11、13/13和100%(24/24)；MRI相应分别为6/11、11/13和70.8%(17/24)，特异性差异有统计学意义(n χ2＝6.231, n P<0.05)。5例骨盆骨转移n 68Ga-PSMA PET/CT显像均为阳性，2例MRI阳性。n 68Ga-PSMA PET/CT显像修正了41.7%(10/24)的中高危前列腺癌患者的盆腔MRI分期。n 结论:68Ga-PSMA PET/CT显像和MRI术前探测中高危前列腺癌及精囊侵犯均具有较高的准确性。n 68Ga-PSMA PET/CT显像对前列腺癌淋巴结及骨转移诊断效能优于MRI。n 68Ga-PSMA PET/CT显像可为中高危前列腺癌提供准确的术前诊断和分期信息。n “,”Objective:To compare the performance of n 68Ga-prostate specific membrane antigen (PSMA) PET/CT and MRI in preoperative diagnosis and staging of primary prostate cancer.n Methods:Twenty-four patients with prostate cancer, who underwent preoperative n 68Ga-PSMA PET/CT and prostate MRI in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology between April 2018 and December 2019, were retrospectively enrolled. The pathological and follow-up results were considered as the gold standard, and diagnostic efficiencies of the 2 imaging methods were compared per patient and per type of lesions (seminal vesicle invasion, bladder neck invasion, lymph node metastasis and bone metastasis). The n χ2 test was used for data analysis.n Results:Prostate cancer was confirmed by pathology in 24 patients, including 6 cases with both seminal vesicle and bladder neck invasion, 5 cases with seminal vesicle invasion and 3 cases with invasion of bladder neck. Gleason scores in patients were as follow: 7 in 9 patients, 8-9 in 15 patients. The detection rates of n 68Ga-PSMA PET/CT and MRI for primary prostate cancer were both 100%(24/24). The sensitivity, specificity and accuracy of n 68Ga-PSMA PET/CT and MRI for detecting seminal vesicle invasion were 10/11, 13/13, 95.8%(23/24) and 9/11, 11/13, 83.3%(20/24), respectively. The specificity and accuracy were significantly different (n χ2 values: 6.231, 13.470, both n P0.05). Furthermore, the sensitivity, specificity and accuracy ofn 68Ga-PSMA PET/CT for detecting pelvic lymph node metastasis were 11/11, 13/13 and 100%(24/24), respectively, and those of MRI for evaluating pelvic lymph node metastasis were 6/11, 11/13 and 70.8%(17/24), and the specificity of the 2 methods were significantly different (n χ2=6.231, n P<0.05). All the 5 patients with pelvic bone metastasis were positive onn 68Ga-PSMA PET/CT imaging, but only 2 of them were positive on MRI. Information from n 68Ga-PSMA PET/CT changed pelvic TNM stage in 41.7%(10/24) patients who underwent MRI for initial staging.n Conclusions:68Ga-PSMA PET/CT imaging and MRI can both accurately detect intermediate- to high-risk primary prostate cancer and seminal vesicle invasion. n 68Ga-PSMA PET/CT imaging is superior to MRI for evaluating lymph nodes and bone metastasis. n 68Ga-PSMA PET/CT provides high accuracy for preoperative diagnosing and staging intermediate- to high-risk prostate cancer.n