Heuck A, Scheidler J, Sommer B, Graser A, Müller-Lisse U G, Massmann J
Radiologisches Zentrum München-Pasing, Munich.
Radiologe. 2003 Jun;43(6):464-73. doi: 10.1007/s00117-003-0906-7.
Accurate diagnosis and staging of prostate cancer (PC) is developing into an important health care issue in light of the high incidence of PC and the improvements in stage-adapted therapy. The purpose of this paper is to provide an overview on the current role of MR imaging and MR spectroscopy in the diagnosis and staging of PC.
Pertinent literature was searched and evaluated to collect information on current clinical indications, study techniques, diagnostic value, and limitations of magnetic resonance imaging and spectroscopy.
Major indications for MR imaging of patients with suspected PC are to define tumor location before biopsy when clinical or TRUS findings are inconclusive, and to provide accurate staging of histologically proven PC to ascertain effective therapy. Current MR imaging techniques for the evaluation of PC include multiplanar high-resolution T2-weighted FSE and T1-weighted SE sequences using combined endorectal and phased-array coils. Using these techniques, the reported accuracy of MR imaging for the diagnosis of extracapsular tumor extension ranges between 82 and 88% with sensitivities between 80 and 95%, and specificities between 82 and 93%. Typical MR findings of PC in different stages of disease, as well as diagnostic problems, such as chronic prostatitis, biopsy-related hemorrhage and therapy-related changes of prostatic tissue are discussed. In addition, the current perspectives and limitations of MR spectroscopy in PC are summarized.
Current MR imaging techniques provide important diagnostic information in the pretherapeutic workup of PC including a high staging accuracy, and is superior to TRUS.
鉴于前列腺癌(PC)的高发病率以及分期适应性治疗的改进,其准确诊断和分期正发展成为一个重要的医疗保健问题。本文旨在概述磁共振成像(MR)和磁共振波谱(MRS)在PC诊断和分期中的当前作用。
检索并评估相关文献,以收集有关磁共振成像和波谱的当前临床适应证、研究技术、诊断价值及局限性的信息。
疑似PC患者进行MR成像的主要适应证是,当临床或经直肠超声(TRUS)检查结果不明确时,在活检前确定肿瘤位置,以及对组织学确诊的PC进行准确分期以确定有效的治疗方案。目前用于评估PC的MR成像技术包括使用直肠内线圈和相控阵线圈组合的多平面高分辨率T2加权快速自旋回波(FSE)和T1加权自旋回波(SE)序列。使用这些技术,报道的MR成像对诊断包膜外肿瘤侵犯的准确率在82%至88%之间,敏感性在80%至95%之间,特异性在82%至93%之间。讨论了PC在疾病不同阶段的典型MR表现,以及诊断问题,如慢性前列腺炎、活检相关出血和前列腺组织的治疗相关改变。此外,总结了MRS在PC中的当前前景和局限性。
目前的MR成像技术在PC的治疗前检查中提供了重要的诊断信息,包括较高的分期准确率,且优于TRUS。