攝護腺癌之磁振造影影像和腫瘤定期

Magnetic Resonance Imaging and Staging of Carcinoma of the Prostate

王家槐(Jia-Hwia Wang) ； 許明輝(Ming-Huei Sheu) ； 李潤川(Rheun-Chuan Lee) ； 鄭慧正(Hui-Cheng Cheng) ； 姜仁惠(Jen-Huey Chiang) ； 張政彥(Cheng-Yen Chang) ； 于俊(Chun Yu)

《中華放射線醫學雜誌》 21卷1期 (1996/02) Pp. 31-37

摘要

評估磁振造影在攝護腺癌之診斷及腫瘤定期所擔任之角色。從民國82年7月至民國83年6月，10例經直腸實施攝護腺生體切片檢查證實為攝護腺癌和4例臨床懷疑罹患攝護腺癌，總共14位男性病人轉介至放射線部接受磁振造影檢查。此14例在接受磁振造影前同時都有接受經直腸超音波檢查及電腦斷層攝影。磁振造影影像所見，有12例在T2為主之影像可在攝護腺周邊區見到低訊號強度病灶。磁振造影腫瘤定期在B期以下有4例，C期有8例，D1期有1例，D2期有1例。磁振造影檢查後，在先前接受攝護腺生體切片檢查之10例中，有3例進一步接受姑息性經尿道攝護腺切除，另外有1例則進一步接受根治性攝護腺摘除。無接受攝護腺生體切片檢查之4例中，有3例接受姑息性經尿道攝護腺切除，另1例則接受根治性攝護腺摘除。磁振造影檢查與病理結果腫瘤位置一致者有7例，其他7例因病理報告無指出那一側有腫瘤存在，故腫瘤位置磁振造影檢查與病理結果無法對照。接受根治性攝護腺摘除之2例，磁振造影之腫瘤定期（B期及C期各1例）與病理結果一致。磁振造影將可以擔任攝護腺癌診斷及腫瘤定期之重要角色。

關鍵字

攝護腺，磁振造影 ； 攝護腺，腫瘤

並列摘要

Purpose: To evaluate the role of magnetic resonance imaging in the diagnosis and tumor staging of carcinoma of the prostate. Materials and methods: From July 1993 to June 1994, a total of 14 cases of carcinoma of the prostate were referred to the Department of Radiology for examination by magnetic resonance imaging (MRI). Of these 10 cases had proved to be carcinoma of the prostate from transrectal biopsy of the prostate, and the other 4 cases were suspected from clinical findings. These 14 cases also received transrectal ultrasonography (TRUS) and computed tomography (CT) of the prostate before MRI. Results: Low signal intensity lesion was noted in the peripheral zone of the prostate in T2-weighted images in 12 cases. Tumor staging of these 14 cases by MRI were: below stage B (4 cases), stage C (8 cases), stage Dl (1 case), and stage D2 (1 case). Among the 10 cases who had previously received transrectal biopsy of the prostate, 3 patients received transrectal resection of the prostate (TRU-P), and 1 patient received radical prostatectomy. Of the four clinically suspicious cases, three cases received TRU-P and the last radical prostatectomy. The locations of the tumors were correct in seven cases by correlation with the pathological results. And correct tumor staging was noted in the two cases which received radical prostatectomy, in correlation with the pathological results. Conclusion MRI can play an important role in the diagnosis and tumor staging of carcinoma of the prostate. But further effort (such as application of endorectal coil) should be made in order to improve the accurary of the diagnosis and tumor staging of carcinoma of the prostate.

並列關鍵字

prostate, MR ； prostate, neoplasms