中国男性前列腺癌MRS体素诊断标准  

~1H-MRS voxel diagnostic criteria of prostate peripheral zone cancer for Chinese male

作　　者：李飞宇[1] 王霄英[1] 肖江喜[1] 蒋学祥[1] 

机构地区：[1]北京大学第一医院医学影像科,北京100034

出　　处：《中国医学影像技术》2009年第5期833-836,共4页Chinese Journal of Medical Imaging Technology

基　　金：首都医学发展科研基金(2007-2006);教育部博士点基金新教师项目资助课题(20070001745)

摘　　要：目的以六分区为基础,研究中国人前列腺外周带癌的1H-MRS体素诊断标准。方法76例接受前列腺MR和1H-MRS检查的患者纳入研究,其中前列腺外周带癌42例,非前列腺癌34例。以超声引导下穿刺活检作为六分区病理诊断依据。利用患者癌区和非癌区可用体素的(Cho+Cre)/Cit比值描绘ROC曲线,通过寻找最佳临界点确定前列腺癌阳性体素1H-MRS诊断标准。结果①癌区体素(Cho+Cre)/Cit比值范围0.395～7.998,平均2.14±1.14;非癌区体素(Cho+Cre)/Cit比值范围0.121～3.537,平均0.83±0.45,两者差异有统计学意义。②根据ROC曲线确定前列腺外周带癌1H-MRS诊断标准:包括D期癌在内时,(Cho+Cre)/Cit≥1.09为阳性体素标准,此时敏感性为85.39%,特异性为81.95%,准确性为83.77%;不包括D期癌时,(Cho+Cre)/Cit≥0.94为阳性体素标准,此时敏感性为64.74%,特异性为81.70%,准确性为76.86%。③炎症可以造成(Cho+Cre)/Cit的升高,使诊断特异性下降。结论通过制定MRS阳性体素诊断标准,1H-MRS有助于初步诊断前列腺外周带癌。Objective To establish the ^1H-MRS diagnostic criteria for prostate peripheral zone cancer. Methods A total of 76 patients with prostate diseases who underwent MRI and MRS were recruited in the study. According to the pathological results obtained by ultrasound guided systemic biopsy, the locations of the prostate cancerous region were assigned to one or more of the sextants. ROC curve was depiched to determine the optimal operating point （OOP） for the cancer detection with the ratio of （ChoWCre）/Cit. Results OThe mean ratio of （Cho＋Cre）/Cit in cancerous sextant was 2.14±1.14, which was 0.83±0.45 in noncancerous sextant （P〈0.05）. （2）Aecording to the ROC analysis, the OOP was determined and interpreted at 1.09 for the ratio of （Cho＋Cre）/Cit with higher sensitivity （85.39%） and specificity （81.95%）. If the patients with stage D Pea were excluded, the OOP was determined at 0.94, respectively, and the sensitivity and specificity was 64. 74% and 81.70%. （3）The ratio of （Cho＋Cre）/Cit increased in inflammation, and the diagnostic specificity decreased. Conclusion With the criteria of positive voxel, ^1H-MRS can be used in the diagnosis of prostate peripheral zone cancer.

关 键 词：前列腺肿瘤 磁共振成像 磁共振波谱 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学]