MRS定量分析对于前列腺癌的诊断价值

Quantitative analysis of MR spectroscopy in diagnosis of prostate cancer

目的分析磁共振波谱(MRS)的(胆碱+肌酸)/枸橼酸盐(CC/C)比值对于前列腺癌(PCa)的诊断价值。方法收集经穿刺活检及手术证实的良性前列腺增生(BPH)11例和PCa11例的MR检查资料,根据穿刺活检结果将前列腺外周带以六分区法分为非癌区及癌区。在MRS代谢图上测量每个分区内的CC/C值,对癌与非癌的数值进行独立样本t检验。结果外周带非癌区及癌区的CC/C值分别为(0.77±0.32)和(2.44±1.12),癌区CC/C值明显大于非癌区(t=13.29,P=0.000);若以0.86作为分界,准确性为75.8%,若以0.99作为分界,准确性为87.9%。结论前列腺MRS中的CC/C值有助于鉴别癌与非癌灶。

Objective To evaluate whether the （choline＋creatine）/citrate （CC/C） ratio from the MR spectroscopy （MRS） can be used to diagnose prostate adenocarcinoma （PCa）. Methods Prostate MRS was performed with a 1.5T MR unit in 11 benign prostate hypertrophy （BPH） patients and 11 PCa patients. All patients were proved by systemic ultrasound guided biopsy and radical prostatectomy. The location of the tumor was marked by the pathologist. Each peripheral zone was divided into 6 regions in the metabolite map and the CC/C ratios were measured in each region by drawing the regions of interest （ROIs）. The difference between PCa and non PCa regions were assessed using the independent-samples t test. Results The CC/C ratios of PCa and non-PCa regions were （2.44±1.12） and （0.77±0.32）, respectively. The CC/C of PCa was signifi- cantly higher （t=13.29, P=0. 000） than that of non-PCa peripheral zone of the prostate. If 0.86 was chosen to be the PCa diagnostic cut point, the accuracy was 75.8%, or if 0.99 was chosen, the accuracy reached 87.9%. Conclusion The CC/C ratio measured from the metabolite map can be used to differentiate PCa from non-PCa.