前列腺癌和前列腺增生的MRI和MRS诊断与鉴别诊断

Study on Prostate Cancer and Benign Prostatic Hyperplasia with MRI and MRS

目的探讨磁共振成像(MRI)和磁共振波谱分析(MRS)对前列腺病变的诊断与鉴别诊断价值。方法回顾性分析30例前列腺病变,其中前列腺癌(Pca)11例,前列腺增生(BPH)19例,对其MRI和MRS影像学表现进行了研究。MRI平扫观察前列腺病变的位置、大小、形态及信号特点,MRS可观察枸橼酸盐(Cit)和胆碱复合物(Cho)、肌酸(Cre)的波峰及化学位移,并测定(Cho+Cre)．Cit值。结果11例PCa在T2 WI图像上表现为外周带的信号减低,其中7例为单侧局灶性,4例为双侧弥漫性; 19例BPH在T2 WI上均显示前列腺移行带和中央带的增大,其中13例表现为局灶性结节状高、低信号,6例表现为弥漫性体积增大,呈均匀低、等信号。MRS显示PCa的Cit峰明显下降,Cho峰升高,(Cho+Cre)．Cit值降低,而BPH病灶各代谢物波峰变化不明显,两者间(Cho+Cre)．Cit值有显著性差异(P＜0．05)。结论常规MRI与MRS的联合应用有利于提高PCa和BPH的诊断与鉴别诊断正确率。

Objective To assess magnetic resonance imaging（MRI） and magnetic resonance spectroscopy （MRS）value in diagnosis of prostate diseases.Methods Magnetic resonance imaging（MRI）and MRS appearances were researched in 30 patients with prostate diseases, 19 cases were benign prostatic hyperplasia（BPH）and 11 cases were prostate cancer（PCa）.MRI observation was focused on the size and configuration of the gland,the location of the lesion,the signal intensity of the tumor.MRS observation included the peak and the chemical shiit of citrate（Cit）, choline（Cho）and creatine（Cre）spectra, and the ratio of（Cho＋Cre）.Cit.Results In 11 cases of PCa, low T2 WI signal intensity area in the peripheral zone was observed,7 cases with localized mono-side and 4 cases with bi-sides diffuse.In 19 cases of BPH,enlargement of the transitional and central zone of the grand was found on T2 WI images,13 of which the hyperplasia presented as focal round high or low-signal intensity nodular lesions and in the other 6 cases,the lesions were characterized by diffuse enlargement and well-distribute low or iso-signal intensity. On MRS,citrate peak was obviously declined and choline peak was ascended with the（Cho＋Cre）.Cit ratio being significantly dropped in PCa（P〈0.05,compared with that in BPH）.Conclusion It is very helpful for the differentiation of BPH with PCa bv using combined MRS and MRI.