前列腺癌：冷冻治疗后的磁共振成像表现

Prostate carcinoma: MR imaging findings after cryosurgery.

作者信息

Kalbhen C L, Hricak H, Shinohara K, Chen M, Parivar F, Kurhanewicz J, Vigneron D B, Carroll P R

机构信息

Department of Radiology, University of California, San Francisco 94143, USA.

出版信息

Radiology. 1996 Mar;198(3):807-11. doi: 10.1148/radiology.198.3.8628875.

DOI:10.1148/radiology.198.3.8628875

PMID:8628875

Abstract

PURPOSE

To determine the morphologic changes in the prostate gland after cryosurgery and to assess the value of magnetic resonance (MR) imaging in detecting residual tumor.

MATERIALS AND METHODS

Twenty-seven patients with prostate carcinoma underwent endorectal MR imaging after cryosurgery. Eighteen patients also underwent MR imaging before cryosurgery. MR findings were correlated with posttreatment clinical data, prostate-specific antigen level, and biopsy results.

RESULTS

Mean prostate volume had decreased by 52% in patients examined 8 weeks or more after cryosurgery. Zonal differentiation was lost in 22 of 27 patients (81%). Areas of intraprostatic necrosis were identified in 14 of 27 patients (52%). A thick capsule enveloped the gland and neurovascular bundles in 24 of 27 patients (89%). Osteonecrosis of the symphysis pubis was seen in six of 27 patients (22%). Positive and negative predictive values for MR assessment of recurrent tumor were 44% and 73%, respectively.

CONCLUSION

Cryosurgery-induced changes in the prostate gland preclude reliable detection of residual prostate carcinoma at MR imaging.

摘要

目的

确定冷冻治疗后前列腺的形态学变化，并评估磁共振（MR）成像在检测残留肿瘤方面的价值。

材料与方法

27例前列腺癌患者在冷冻治疗后接受了直肠内MR成像检查。18例患者在冷冻治疗前也接受了MR成像检查。将MR检查结果与治疗后的临床数据、前列腺特异性抗原水平及活检结果进行相关性分析。

结果

在冷冻治疗8周或更长时间后接受检查的患者中，前列腺平均体积减少了52%。27例患者中有22例（81%）的前列腺分区结构消失。27例患者中有14例（52%）发现前列腺内存在坏死区域。27例患者中有24例（89%）的腺体和神经血管束被一层厚包膜包裹。27例患者中有6例（22%）出现耻骨联合骨坏死。MR评估复发性肿瘤的阳性预测值和阴性预测值分别为44%和73%。