前列腺癌的MR波谱成像中体线圈与直肠内线圈的比较  

MR spectroscopic imaging studies of prostate cancer： comparison of body coil and endorectal coil

作　　者：李新民[1] 王霄英[1] 郭雪梅[1] 王鹤[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大学前沿交叉学科研究院功能成像研究中心,100034

出　　处：《中华放射学杂志》2009年第11期1165-1169,共5页Chinese Journal of Radiology

基　　金：首都医学发展基金资助项目（2007-2006）

摘　　要：目的比较体线圈（BODY）与直肠内线圈（ERC）MRS对前列腺癌的定性诊断效能，探讨BODYMRS临床应用的可行性。方法12例取得穿刺病理结果的前列腺外周带癌患者，其中6例为前列腺癌，6例除外了前列腺癌。12例全部完成BODYMRS检查，其中7例同时完成ERCMRS检查。以六分区法对照穿刺结果进行MRS定量分析，分别测量每个区域内癌与非癌区（胆碱＋肌酸）／枸橼酸盐[（Cho＋Cre）／Cit]的比值，并采用Wilcoxon符号等级检验进行比较，计算BODYMRS对前列腺癌的诊断准确性。结果（1）癌区与非癌区体素（Cho＋Cre）／Cit比较：BODY组（7例）癌区体素比值中位数1．744（0．295—7．998），非癌区中位数0．412（0．112～2．113），两者差异有统计学意义（Z=-9．159，P〈0．01）。ERC组（7例）癌区体素比值中位数为1．975（0．479～7．998），非癌区中位数为0．400（0．104～2．232），两者差异有统计学意义（Z=-9．200，P〈0．01）。BODY与ERC组间比较：癌区体素组间比较差异无统计学意义（Z=-0．105，P〉0．05），非癌区体素组间比较差异无统计学意义（Z=-0．692，P〉0．05）。（2）ROC分析：7例BODY与ERC组曲线下面积（Az值）分别为0．931、0．935，两者比较差异无统计学意义（P=0．851）；应用BODYMRS12例患者组Az值为0．935，敏感度、特异度分别为82．2％和88．2％。结论BODY与ERC的MRS对前列腺外周带癌定性诊断效能接近，临床应用具有可行性。Objective To compare the diagnostic value of MRS acquired by body coil （BODY） and endorectal Coil （ERC） in the detection of prostate cancer. Methods MRI and 3D MRS were performed in 12 patients with prostate disease, in which 6 of them were proved to have prostate cancer and the other 6 noncancerous disease. Both BODY and ERC MRS were performed in 7 patients, and only BODY MRS was performed in the other 5 patients. All MRS data were quantitatively assessed with a per-sextant method. The metabolic ratio of （Choline ＋ Creatine）/Citrate [ （Cho ＋ Cre）/Cit] was measured in each ROI. ROC analysis was carried out to assess and to compare the diagnostic value of BODY and ERC MRS in patients with prostate cancer with Wilcoxon test. Results （ 1 ） The ratios of （ Cho ＋ Cre）/Cit in the prostate cancer group（ median 1. 744,0. 295 to 7.998 ） was statistically higher than that in the non-prostate cancer group （median 0. 412,0. 112 to 2. 113）acquired by using BODY MRS（Z = -9. 159,P 〈0. 01 ）. （2） The ratios of （ Cho ＋ Cre）/Cit in the prostate cancer group（ median 1. 975,0. 479 to 7. 998 ） was statistically higher than that in the non-prostate cancer group （ median 0. 400,0. 104 to 2. 232 ） acquired by using ERC MRS （ Z = - 9. 200, P 〈 0. 01 ）. （3） The mean ratios of （ Cho ＋ Cre）/Cit in the prostate cancer group and in the nonprostate cancer group acquired by using both coils were not of statistically significant difference （P 〉 0. 05 ）. （4） ROC analysis for diagnosing prostate cancer showed no significant difference （P = 0. 851 ） between the areas under the curve of BODY and that of ERC MRS（ Az = 0. 931 and 0. 935 respectively）. Conclusion The BODY MRS could provide comparable diagnostic efficacy to ERC MRS in patients with prostate cancer.

关 键 词：前列腺癌 磁共振波谱学 对比研究 

分 类 号：R686[医药卫生—骨科学]