慢性前列腺炎的MRS表现  

MR Spectroscopy Findings of Chronic Prostatitis

作　　者：王芳[1] 李又成[1] 黎金林[1] 李剑敏[2] 李建策[1] 吴恩福[1] 

机构地区：[1]温州医学院附属第一医院放射科科,浙江温州325000 [2]温州医学院附属第一医院病理科,浙江温州325000

出　　处：《实用放射学杂志》2011年第3期407-409,412,共4页Journal of Practical Radiology

摘　　要：目的 探讨3.0T MR 体外相控阵线圈MRS在慢性前列腺炎的表现及其病理基础.方法 分析经手术或穿刺活检证实的7例表现为MR T2WI低信号的慢性前列腺炎的MRI、MRS所见.所有病例均应用3.0T MR 体外相控阵线圈行MR常规检查、扩散加权成像及MRS检查.MRS测量前列腺T2WI低信号区及对侧正常区域的枸橼酸盐（Cit）、胆碱（Cho）、肌酸（Cr）的相对值及（ 胆碱＋肌酸） /枸橼酸盐[（Cho＋Cr）/Cit]的比值,并计算T2WI低信号病变区与对侧正常区域的胆碱比值及枸橼酸盐比值.分析病变区域的病理镜下所见.结果 慢性前列腺炎病变区域与对侧正常区域的胆碱含量比值为1.05±0.23,病变区域与对侧正常区域的枸橼酸盐含量比值为0.31±0.14,病变区域的（Cho＋Cr）/Cit比值（1.77±0.41）明显高于对侧正常区域的（Cho＋Cr）/Cit比值（0.58±0.15）,两者有明显统计学差异（P＜0.01）.病理上,慢性前列腺炎病变区域见淋巴细胞浸润、腺泡及导管不同程度萎缩、闭塞.结论 在常规MR T2WI上表现为低信号的慢性前列腺炎,在MRS上（Cho＋Cr）/Cit比值升高,与前列腺癌表现极为相似,但慢性前列腺炎的（Cho＋Cr）/Cit比值升高主要是因为病变区域的枸橼酸盐含量降低,而其胆碱含量变化不明显.Objective To retrospectively summarize the findings of three-dimensional MR spectroscopy（MRS） of chronic prosta- titis at 3.0 Tesla using a pelvic phased-array coil. Methods MR imaging and MRS at 3-Tesla whole-body scanner were performed in 7 patients with pathologically confirmed chronic prostatitis. Relative levels of the prostate metabolites Citrate（Cit） ,Choline （Cho） and Creatine（Cr） ,and the （Cho＋Cr）/Cit ratio were calculated in the prostatic regions which appeared as low signal intensity and opposite region with normal signal intensity on T1 WI, and the Cho ratio and the Cit ratio were also measured in the above regions, respectively. Results The rates of Cho and Cit between the lesions and normal regions were 1.05 ±0.23 and 0.31 ±0.14, respectively, the rate of（Cho＋Cr）/Cit in the lesions（ 1.77±0.41 ） was obviously higher comparing with that in normal region（0.58±0.15） ,there was significant difference statistically between them. At pathology,the lesions showed lymphocyte-infilitration,acinus and ductal atrophy and obstruction in different degree. Conclusion In chronic prostatitis with low signal intensity on T2WI, MRS shows an elevated（Cho＋Cr）/Cit ratio, that is mimical prostate cancer,which is as a result of reduced Cit, but Cho is normal.

关 键 词：前列腺 慢性前列腺炎 磁共振成像 磁共振波谱 

分 类 号：R697.33[医药卫生—泌尿科学] R445.2[医药卫生—外科学]