目的: 探讨体素内不相干运动弥散加权成像(IVIM-DWI)技术在前列腺癌中的诊断价值,并结合CD34病理染色结果,分析IVIM-DWI各灌注相关参数的病理生理学基础.方法:采用3.0T核磁共振对符合纳入标准的前列腺癌患者(PCa组)24例[平均年龄(74.29±7.77)岁]及良性前列腺增生患者(BPH组)21例[平均年龄(70.48±9.40)岁],行IVIM-DWI检查,应用经典双指数函数模型对所得数据进行处理分析得到相关定量参数D、D*、f值.对行根治性切除手术的前列腺癌及良性前列腺增生患者的病理切片行CD34染色并计算微血管密度(MVD).结果:PCa组中D值及f值较BPH组明显减低,而D*值明显升高,差异有统计学意义(P<0.05).PCa组中D*值与MVD显著正相关(r=0.793,P<0.05),BPH组中f值与MVD显著正相关(r=0.766,P<0.05).结论:IVIM-DWI各相关参数(D、D*、f值)在前列腺癌与良性前列腺增生的鉴别中具有明确的诊断价值.前列腺癌中D*值的升高与前列腺癌组织内微血管密度密切相关,而f值的减低可能与癌灶中血管通透性的异常有关.%Aim:To discuss the value of IVIM-DWI in the diagnosis of prostate cancer, and further investigate the pathophysiological characteristics of the perfusion related quantitative parameters derived from the intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) combing the the results of CD34 staining.Methods: Twenty-four PCa patients (mean age 74.29±7.77 years) and twenty-first BPH patients (mean age 70.48±9.40 years)met the inclusion criteria underwent the IVIM-DWI scanning with 3.0 T MRI device.The IVIM-DWI derived parameters (D, D*,high ADC and f values) were calculated with bi-exponential function model.Meanwhile, the patients' histological samples obtained radical resection surgery were stained with CD34, and the MVD results were calculated.Results: The D and f values in PCa were significantly lower than in BPH (P<0.05), while the D* value was significantly higher (P<0.05).In PCa group, the D* value presented significant positive correlation with MVD (r=0.793,P<0.05).In BPH group, f value presented significant positive correlation with MVD (r=0.766, P<0.05).Conclusion:The quantitative parameters derived from IVIM-DWI have the ability to identify the PCa.The increased D* value in PCa can reflects the change of the MVD.While the decreased f value in PCa may be related with the abnormal permeability.
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