Multi-parametric MR imaging of the anterior fibromuscular stroma and its differentiation from prostate cancer.
Multi-parametric MR imaging of the anterior fibromuscular stroma and its differentiation from prostate cancer.
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前纤维肌间质的多参数 MR 成像及其与前列腺癌的鉴别。
DOI：
10.1007/s00261-016-0951-0
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发表时间：
2017
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影响因子：
--
通讯作者：
Oto,Aytekin
中科院分区：
文献类型：
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作者：
Ward,Emily;Baad,Michael;Peng,Yahui;Yousuf,Ambereen;Wang,Shiyang;Antic,Tatjana;Oto,Aytekin
目的描述正常前部纤维肌间质 (AFMS) 的 MP-MRI 特征，并确定可将其与前前列腺癌区分开来的 MR 成像结果。方法我们回顾了 2012 年 10 月至 2014 年 8 月期间接受术前 MRI 和前列腺切除术的患者的 MP-MR 图像和组织病理学。37 名直径大于 5 毫米的前前列腺癌患者和 40 名直径大于 5 毫米的前前列腺癌患者 本研究不包括前部癌症。与组织学和 MR 图像相关后，比较正常 AFMS 和前前列腺癌的大小、对称性、T2、DWI 特征和增强模式。结果正常 AFMS 在 T2 加权图像上呈低信号且对称（37/40，93%），而前前列腺癌在 T2 加权图像上也呈低信号，主要是低信号。 不对称 (6/37, 16%) (P< 0.001)。在高 b 值 DWI 上，与正常外周区相比，AFMS 主要为低信号（36/40，90%），而前前列腺癌主要为高信号（30/37，81%）（P < 0.001）。前前列腺癌的平均 ADC 值和第 10 个百分点的 ADC 值分别低于正常 AFMS（7.14 vs. 8.33 (10−4mm2/s),P<0.01）和（5.73 vs. 6.95 (10−4mm2/s),P<0.01）。在 DCE-MR 图像上，AFMS 显示 1 型增强曲线（35/39，90%），而前前列腺癌仅显示 3 型（23/37，62%）或 2 型增强曲线（14/37，38%）（P<0.001）。结论对称 T2 外观、低信号高 b 值 DWI 信号、相对较高的 ADC 值和 AFMS 的 1 型增强模式有助于将其与前前列腺癌区分开来。
PurposeTo describe MP-MRI features of the normal anterior fibromuscular stroma (AFMS) and identify MR imaging findings that can differentiate it from anterior prostate cancer.MethodsWe reviewed MP-MR images and histopathology of patients who underwent pre-operative MRI and prostatectomy between October 2012 and August 2014. Thirty-seven patients with anterior prostate cancer larger than 5 mm and 40 patients with no anterior cancer were included in this study. After correlation with histology and MR images, the size, symmetry, T2, DWI characteristics, and enhancement pattern of normal AFMS and anterior prostate cancer were compared.ResultsNormal AFMS was hypointense and symmetric on T2-weighted images (37/40, 93%), whereas anterior prostate cancers, while also hypointense on T2-weighted images, were predominantly asymmetric (6/37, 16%) (P< 0.001). On highb-value DWI, AFMS was predominantly hypointense (36/40, 90%), whereas anterior prostate cancers were predominantly hyperintense (30/37, 81%) compared to the normal peripheral zone (P< 0.001). The mean ADC and tenth percentile ADC values of anterior prostate cancers were lower than normal AFMS (7.14 vs. 8.33 (10−4mm2/s),P< 0.01) and (5.73 vs. 6.95 (10−4mm2/s),P< 0.01), respectively. On DCE-MR images, AFMS demonstrated a type 1 enhancement curve (35/39, 90%), whereas anterior prostate cancers demonstrated only either a type 3 (23/37, 62%) or type 2 enhancement curve (14/37, 38%) (P< 0.001).ConclusionsSymmetric T2 appearance, hypointense highb-value DWI signal, relatively higher ADC values, and Type 1 enhancement pattern of the AFMS can be helpful in its differentiation from anterior prostate cancers.