Mueller-Lisse U G, Mueller-Lisse U L, Zamecnik P, Schlemmer H-P W, Scherr M K
Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Campus Innenstadt, Ziemssenstrasse 1, Munich, Germany.
Radiologe. 2011 Mar;51(3):205-14. doi: 10.1007/s00117-010-2061-2.
Diffusion-weighted magnetic resonance imaging (DWI) can complement MRI of the prostate in the detection and localization of prostate cancer, particularly after previous negative biopsy. A total of 13 original reports and 2 reviews published in 2010 demonstrate that prostate cancer can be detected by DWI due to its increased cell density and decreased diffusiveness, either qualitatively in DWI images or quantitatively by means of the apparent diffusion coefficient (ADC). In the prostate, the ADC is influenced by the strength of diffusion weighting, localization (peripheral or transitional zone), presence of prostatitis or hemorrhage and density and differentiation of prostate cancer cells. Mean differences between healthy tissue of the peripheral zone and prostate cancer appear to be smaller for ADC than for the (choline + creatine)/citrate ratio in MR spectroscopy. Test quality parameters vary greatly between different studies but appear to be slightly better for combined MRI and DWI than for MRI of the prostate alone. Clinical validation of DWI of the prostate requires both increased technical conformity and increased numbers of patients in clinical studies.
扩散加权磁共振成像（DWI）可在前列腺癌的检测和定位方面补充前列腺MRI检查，尤其是在先前活检结果为阴性之后。2010年发表的总共13篇原始报告和2篇综述表明，由于前列腺癌细胞密度增加和扩散性降低，无论是在DWI图像上定性检测，还是通过表观扩散系数（ADC）进行定量检测，DWI均能检测出前列腺癌。在前列腺中，ADC受扩散加权强度、定位（外周带或移行带）、前列腺炎或出血的存在以及前列腺癌细胞的密度和分化程度影响。在外周带健康组织与前列腺癌之间，ADC的平均差异似乎比磁共振波谱中（胆碱+肌酸）/枸橼酸盐比率的差异要小。不同研究之间的检测质量参数差异很大，但联合MRI和DWI的检测质量似乎略优于单纯的前列腺MRI。前列腺DWI的临床验证需要在临床研究中提高技术一致性并增加患者数量。
