磁共振灌注成像与前列腺癌分期、分级及PSA的相关性研究  

Correlative Study on Perfusion Weighted MR Imaging,Tumor's Stage,Histological Grade and PSA in Prostatic Carcinoma

作　　者：王锡臻[1] 王滨[1] 刘金刚[1] 牛庆亮[2] 张强[3] 

机构地区：[1]潍坊医学院附属医院影像中心 [2]潍坊市中医院放射科 [3]潍坊市人民医院放射科

出　　处：《实用放射学杂志》2008年第7期925-927,930,共4页Journal of Practical Radiology

基　　金：国家自然科学基金项目(30470518);国家教育部留学回国人员启动基金项目;山东省1020工程(卫生系统杰出学科带头人和中青年重点科技人才)基金

摘　　要：目的探讨磁共振灌注成像的相关指标与前列腺癌Gleason分级、TNM分期及PSA的相关性。方法分析经穿刺活检组织病理学证实的前列腺癌49例,记录患者的临床资料。使用GE Echo-speed 1.5T超导成像仪,联合应用盆腔相控阵线圈和直肠内表面线圈,采用单次激发平面回波序列进行灌注成像。通过GE高级工作站4.2进行数据处理,采用闭孔内肌灌注指标作为内部参考,计算得到不同感兴趣区的相对灌注指标:相对负增强积分、相对增强平均时间、相对达峰值时间、相对信号降低最大斜率及相对血流速度,分析相对灌注指标与前列腺癌Gleason分级、TNM分期及PSA的相关性。结果前列腺癌的相对负增强积分(rNEI)、增强平均时间(rMTE)、达峰值时间(rTTM)、信号降低最大斜率(rMSD)及血流速度(rBF)的平均值分别为6.44、0.71、0.68、1.93和8.17。前列腺癌的灌注指标与正常前列腺外周带及BPH存在明显差异(P<0.05)。前列腺癌rNEI与Gleason分级、TNM分期及PSA水平存在正相关关系(r=0.48;0.52;0.63,P<0.05);达峰值时间与Gleason分级、TNM分期存在负相关关系(r=-0.46、-0.51,P<0.05)。结论磁共振灌注指标与前列腺癌Gleason分级、TNM分期及PSA存在相关性,根据PWI指标可对前列腺癌的生物学特性进行初步评估。Objective To investigate the relationship between MR perfusion weighted imaging（ PWI） and Gleason grade, TNM and PSA level of prostate cancer（ Pca）. Methods The clinic and pathologic informations of 49 patients with histologically proven Pca were studied retrospectively. The examinations were performed in the supine position using a 1.5T superconductive magnet Echo - speed scanner with an intergrated endorectal surface coil and pelvic phased array multi - coil. PWI was acquired using a modified single shot SE echo planar imaging （ EPI） sequence. All of the data was transferred to GE Advanced Workstation 4.2. The indexes of PWI were calculated by Functool 2 which included signal intensity- time curve （SI- TC） , negative enhancement integral （NEI） , mean time to enhance （MTE ） , time to minimum （ TTM ） , maximum slope of decrease （ MSD ） and blood flow （ BF） . In order to eliminate the variation of individuals, the indexes of obtura- tor internus were used as internal references . Results The mean value of rNEI , rMTE , rTTM , rMSD and rBF in prostate cancer were 6.44,0.71,0.68,1.93 and 8.17 respectively . The rNEI , rTTM and rMSD of prostate cancer were higher than that in BPH and PZ （ P 〈 0.05 ） , while the MTE and TTM in prostate cancer were shorter than that of normal PZ and BPH （ P 〈 0.05 ）. Positive correlation was found between rNEI and Gleason grade, TNM and PSA level （ r = 0. 48 ; 0. 52 ; 0.63, P 〈 0.05 ）. There was a negative correlation between rTTM and gleason grade, TNM of prostate cancer （ r = - 0.46 ; - 0. 51, P 〈 0.05 ）. Conclusion Some indexes of PWI are correlated with clin ical data of prostate cancer. PWI can be used to estimate the biological behavior of prostate cancer.

关 键 词：前列腺癌 磁共振成像 灌注成像 

分 类 号：R737.21[医药卫生—肿瘤] R445.2[医药卫生—临床医学]