磁共振波谱与弥散成像在前列腺癌筛选中的价值  

Value of Magnetic Resonance Spectroscopy and Diffusion weighted Imaging in the Screening of Prostate Cancer

作　　者：汪加朋[1] 汪清[2] 胡岚亭[2] 蒋杰[3] 

机构地区：[1]石河子大学医学院,新疆石河子832000 [2]新疆维吾尔自治区人民医院泌尿二科,新疆乌鲁木齐830001 [3]新疆维吾尔自治区人民医院放射影像中心,新疆乌鲁木齐830001

出　　处：《医学临床研究》2011年第1期53-56,共4页Journal of Clinical Research

摘　　要：【目的】探讨磁共振波谱（MRS）与弥散成像（DWI）在疑似前列腺癌（PCa）筛选中的应用价值。【方法】选择122例术前前列腺特异性抗原（PSA）异常、直肠指检或B超异常的疑似PCa患者，其中69例采用MRS检查，53例采用DWI检查，测量感兴趣区的（Cho＋Cr）／Cit比值或表观弥散系数（ADC）值。对比术后病检结果，分析比较MRS组及DWI组灵敏度、特异度及ROC曲线下面积。【结果】所有患者均于磁共振检查1个月内获得病理结果，其中MRS组PCa病人21例，前列腺增生（BPH）病人48例。PCa与BPH（Cho＋Cr）／Cit比值分别为（1．19±1．08）及（3．23±2．30），二者间存在显著差异（P〈0．05）。ROC曲线下面积0．780，敏感度及特异度分别为81％及75％。DWI组PCa病人15例，BPH病人38例。在取b值1000s／mm。时，PCa与BPH的ADC值分别为（0．783±0．14）×10^-3mm^2／s及（1．39±0．15）×10^-3mm^2／s，两者间差异有统计学意义（P=0．000）。ROC曲线下面积0．862，敏感性与特异性分别为78．1％及91．5％。【结论】MRS及DWI均是无创的功能性磁共振成像检查，在PCa筛选方面均具有较高诊断价值，其中DWI诊断效能高于MRS。[Objective]To investigate the application value of magnetic resonance spectroscopy（MRS） and diffusion weighted imaging（DWI） in the screening of suspected prostate cancer（Pca）. [Methods] Totally 122 cases of suspected Pca with abnormal PSA, digital rectal examination or B-ultrasound before operation were selected. In all patients, 69 cases underwent MRS examination and 53 cases performed DWI examination to measure the （Cho ＋ Cr）/Cit or apparent diffusion coefficient values in each area of interest. The pathological results after the operation were compared. The specificity, sensitivity and the area under the ROC curves were analyzed and compared between MRS group and DWI group. [Results]All of the patients underwent MRI and pathological examination within a month. In MRS group, 21 cases were prostate cancer and 48 cases were benign prostate hyperplasia. The （Cho＋Cr）/Cit in prostate cancer and benign prostate hyperplasia were 1.19± 1.08 and 3.23±2.30, respectively, and there was significant difference between them（ P 〈0.05）. The area under the ROC curves was 0. 780. The sensitivity and specificity were 81% and 75%, respectively. In DWI group, 15 cases were prostate cancer and 38 cases were benign prostate hyperplasia. When taking b-value 1000s/mm2 , the ADC values in prostate cancer and benign prostate hyperplasia were （0. 783±0.14）× 10^-3 mm2/s and （1.39± 0.15） × 10^-3 mm^2/s, respectively, and there was significant difference between them（ P = 0. 000）. The area under the ROC curves was 0. 862. The sensitivity and specificity of DWI were 78. 1% and 91.5 %, respectively. [ConclusionlBoth MRS and DWI are the non-invasive functional MRI examination methods. They have higher diagnostic value in the screening of Pea, but DWI is better than MRS in the diagnostic efficiency.

关 键 词：前列腺肿瘤 磁共振成像 

分 类 号：R737.25[医药卫生—肿瘤]