3D^1HMRSI对外周带前列腺癌鉴别诊断价值的初步研究  

The value of three-dimensional proton MR spectroscopic imaging in the differential diagnosis of prostate cancer in peripheral zone: preliminary study

作　　者：秦海燕[1] 白人驹[1] 王希明[1] 赵新[1] 

机构地区：[1]天津医科大学总医院放射科,天津300052

出　　处：《医学影像学杂志》2005年第11期978-982,共5页Journal of Medical Imaging

摘　　要：目的:探讨3D1HMRSI(three dimensional proton MR spectroscopic imaging)研究外周带前列腺癌(PCa)的代谢特点,及对外周带PCa的鉴别诊断价值。方法:分析18例良性前列腺增生(BPH)和21例PCa的3D MRSI表现。测量外周带PCa体素及BPH外周带体素的(Cho+Cre)/Cit及Cho/Cre,并比较它们之间的差异。结果:BPH的外周带波谱主要表现为Cit高耸,Cho次之,Cre最低;PCa波谱主要表现为Cit峰明显下降甚至消失,Cho显著升高,两者波峰可呈现倒置,(Cho+Cre)/Cit>0.86。PCa体素的(Cho+Cre)/Cit显著高于BPH体素,且两者仅存在小部分重叠,PCa体素的Cho/Cre也显著高于BPH体素,但两者存在较大部分重叠;经ROC曲线分析得出(Cho+Cre)/Cit对外周带PCa的鉴别诊断效能高于Cho/Cre,(Cho+Cre)/Cit对外周带PCa的最佳诊断阈值为1.16。结论:外周带PCa的3D MRSI表现具有特征性,(Cho+Cre)/Cit为诊断外周带PCa的有效指标,以(Cho+Cre)/Cit>1.16作为诊断标准,可获得较高的敏感度、特异度和准确度(分别为99.3%、99.2%、99.3%)。Objective：To explore the metabolic characteristic of prostate cancer （PCa） in peripheral zone （PZ） with 3D^1 H MRSI and evaluated the value of 3D 1 H MRSI in the differential diagnosis of prostate cancer in PZ.Methods：3D^1 H MRSI findings were reviewed in 18 cases of benign prostatic hyperplasia （BPH） and 21 cases of PCa . （Cho ＋ Cre）/Cit and Cho/Cre ratios of PCa and BPH PZ were retrospectively measured, （Cho ＋ Cre）/Cit and Cho/Cre of PCa voxels were compared with that of BPH voxels. Results： PZ of BPH showed dominant Cit, which was markedly higher than Cho and Cre. Significantly higher choline levels and lower citrate levels were observed in PCa than in BPH, （Cho ＋ Cre）/Cit 〉 0.86. It showed statistically significant differences between （ Cho ＋ Cre）/Cit ratios of PCa voxels and BPH voxels, PCa voxels had minimal overlap with BPH voxels. It also showed statistically significant differences between Cho/Cre ratio of PCa voxels and BPH voxels, but there were some overlap between two groups. ROC analysis showed that diagnosis efficacy of PCa with Cho ＋ Cre/Cit was better than with Cho/Cre, the best threshold of Cho ＋ Cre/Cit was 1.16. Conclusion：3D^1HMRSI can be successfully applied to the diagnosis of cancer in the PZ on the basis of the elevation of Cho and the reduction Cit in cancerous tissue compared with BPH PZ tissue. The ratio of （Cho＋ Cre）/Cit 〉 1.16 is a preferable threshold to differentiate PCa in PZ from BPH.

关 键 词：前列腺增生 前列腺癌 磁共振成像 3D氢质子磁共振波谱成像 

分 类 号：R697.3[医药卫生—泌尿科学] R445.2[医药卫生—外科学]