【摘要】 目的探讨磁共振增强扫描结合弥散加权成像对前列腺脓肿诊断的价值。方法对13例经临床或病理证实的前列腺脓肿病例和13例健康体检者进行回顾性分析,分为前列腺脓肿组和正常组,所有病例均行盆腔磁共振增强扫描,进行增强扫描结合弥散加权成像(DWI)图像和ADC值分析。结果 13例前列腺脓肿MRI表现如下:单发型5例(中央带1例和外周带4例),多发型4例(多位于外周带或者累及中央带)和累及或合并周围组织器官脓肿4例(如精囊、尿道海绵体、肛提肌、闭孔内肌、肛管直肠旁和附睾)。最大的单个脓肿大小约26mm×15mm×28mm,而多发脓肿直径约4～35mm。前列腺脓肿组PSA和血常规白细胞值较正常组高,而ADC值明显较正常组低,差异有统计学意义(P<0.05);DWI表现为弥散明显受限,DWI的显著高信号是脓肿的特征性表现;磁共振增强扫描显示脓肿壁的增强表现也可反映其所处的不同组织病理发展时期。结论磁共振增强扫描结合弥散加权成像对前列腺脓肿的进展和分期提供了全面而重要的信息。更多还原

【Abstract】 Objective To evaluate the diagnostic value of enhanced magnetic resonance imaging combined with diffusion weighted imaging in prostate abscess.Methods 13 cases of prostatic abscess confirmed by clinic or pathology and 13 cases of healthy physical examination were analyzed retrospectively,which were divided into prostate abscess group and normal group.All patients underwent pelvic MRI enhanced examination,then analysis of enhanced scanning combined with dispersion weighted imaging(DWI) image and ADC values was performed.Results MRI findings of 13 cases of prostate abscess were as follows:5 cases were single(1 case with central zone and 4 cases with peripheral zone),4 cases were multiple(mostly located in the peripheral zone or involving the central zone) and 4 cases were involved or combined with abscess of surrounding tissues and organs(such as seminal vesicle,urethral cavernous body,levatorani,obturator internus,paranorectal and epididymis).The maximum size of a single abscess was about 26 mm×15 mm×28 mm,and the diameter of multiple abscesses ranged from 4 mm to 35 mm.The PSA and blood routine white blood cell values in the prostate abscess group were higher than those in the normal group,while the ADC values were significantly lower than those in the normal group,with statistical significance(P<0.05).DWI showed significantly limited diffusion and significantly high signal.Enhanced magnetic resonance imaging showed that the enhanced appearance of the abscess wall could also reflect the different histomathological stages of the abscess.Conclusion Resonance enhanced scanning combined with diffusion weighted imaging provides comprehensive and important information on the progression and staging of prostate abscess.更多还原