Multiparametrische Magnetresonanztomografie der Prostata – Technik und klinische Anwendungen

Zusammenfassung

Die multiparametrische Magnetresonanztomografie umfasst die ¹H-Magnetresonanzspektroskopie, die diffusionsgewichtete Bildgebung und die dynamische kontrastmittelgestützte Magnetresonanztomografie. Für die Prostatadiagnostik werden diese Methoden immer häufiger zusätzlich zu den konventionellen T 2- und T 1-gewichteten Bildern angewendet. Der erste Teil dieses Reviews geht daher für jede Methode getrennt auf die Technik, die wichtigsten diagnostischen Parameter und deren pathohistologischen Hintergrund ein. Ferner werden in diesem Teil die für jede Methode charakteristischen Merkmale des Prostatakarzinoms und des nicht karzinomatösen Prostatagewebes aufgezeigt. Im zweiten, klinischen Teil werden die klinischen Anwendungen wie frühzeitiger Nachweis, Lokalisation, Staging und Rezidivdiagnostik diskutiert und die aktuellen Veröffentlichungen auf diesem Gebiet zusammengefasst. Des Weiteren werden mögliche zukünftige klinische Anwendungen wie Bestimmung der biologischen Aggressivität und des Tumorvolumens aufgezeigt.

Abstract

Multiparametric magnetic resonance imaging (MRI) includes 1 H magnetic resonance spectroscopy, diffusion-weighted imaging, and dynamic contrast-enhanced MRI. These new MRI techniques are increasingly being used to supplement conventional T 2 and T 1-weighted MR sequences in prostate imaging. The first part of this review outlines each of these techniques, the most important diagnostic parameters, and the pathophysiological background. The characteristic features of prostate cancer and noncancerous prostate tissue as depicted with each of the three techniques are presented. The second, clinical part outlines the diagnostic applications of the three MRI techniques for the early detection and localization of prostate cancer, staging, and the identification of recurrent cancer and discusses the most recent publications in this field. The review concludes with a look at emerging clinical applications such as the evaluation of biological aggressiveness and tumor volume.

Key words

MR functional imaging - MR diffusion/perfusion - MR spectroscopy - prostate

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