臨床泌尿器科67巻11号

2013年10月発行

特集 良性・悪性の鑑別に迷う泌尿器病変ラインアップ

5．前立腺病変

良性・悪性の鑑別に迷う前立腺病変―Multiparametric prostate magnetic resonance imagingの可能性：初回前立腺生検癌陰性患者の再生検を勧める有力なパラメータとなり得るか？　PSA監視療法での監視方法の有力なパラメータとなり得るか？

著者： 西山勉¹ 麻谷美奈²

所属機関： ¹新潟大学大学院医歯学総合研究科腎泌尿器病態学分野 ²新潟大学大学院医歯学総合研究科腫瘍放射線医学分野

ページ範囲：P.889 - P.895

文献概要

要旨　前立腺癌疑いで生検を行っても癌が発見されない場合，再生検を行う。また，病理組織学的に前立腺癌と診断されても直ちに治療せず，PSA監視療法が推奨される場合も多くなってきている。PSA監視療法時に，再生検による病理組織学的診断が重視される。Magnetic resonance imaging（MRI）は優れたコントラスト分解能で，解剖学的構造を明確に描出できるが，小さな癌の検出能や被膜外浸潤の診断能は満足できる成績ではない。しかし，MRIは他のmodalityにはない可能性を秘めており，病理診断と並ぶ情報が前立腺生検前に得られる可能性がある。初回前立腺生検癌陰性患者や，PSA監視療法での有力なパラメータとして，multiparametric prostate MRI（mpMRI）の可能性を検討してみる。

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