飞利浦1．5T双梯度磁共振扫描仪前列腺良恶性疾病的三维氢质子磁共振波谱成像研究

Three-dimensional- ^1H- magnetic resonance spectroscopy imaging study of benign and malignant prostatic diseases by Philips 1.5T dual-gradient magnetic resonance scanner

目的研究飞利浦1．5T双梯度磁共振扫描仪（Philips Intera 1．5T Achieva Nova—Dual MR）前列腺良恶性疾病三维氢质子磁共振波谱（3D—^1H—MRS）成像的可靠性。方法使用荷兰飞利浦公司生产的1．5T双梯度磁共振扫描仪，心脏相控阵线圈，头部三维磁共振波谱（3D—MRS）软件，通过对2008年4月至2008年7月选取的12例健康志愿者前列腺3D-^1H—MRS检查并获得成像的各项参数。选取2008年7月至2009年1月临床病理证实前列腺癌患者12例，临床穿刺活检或实验室检查证实前列腺炎患者32例、前列腺增生患者24例，行3D-^1H—MRS检查，分析对比健康志愿者和各种前列腺良恶性疾病的前列腺3D-^1H—MRS图像。结果前列腺3D-^1H—MRS图像清晰，健康志愿者和前列腺良恶性疾病的前列腺3D-^1H—MRS图中胆碱（cho）的化学位移共振峰位于3．25ppm；肌酸（cre）的化学位移共振峰位于3．06ppm；枸橼酸盐（cit）的化学位移共振峰位于2．65ppm。前列腺良性病变（前列腺炎、前列腺增生）和正常前列腺外周带的MRS图均表现为cho峰较高，cre峰较低，ere峰与cho峰紧邻，cit峰最高。前列腺癌MRS图表现为cho峰最高，cre峰较低，cit峰明显降低。前列腺炎、前列腺癌、前列腺增生和正常前列腺的（cho＋cre）／cit值分别为0．55±0.21、4．02±1．96、0．64±0．22、0．43±0．14，前列腺癌组与其他各组间差异均有统计学意义（P〈0．05），但正常前列腺和前列腺炎、前列腺增生组间差异没有统计学意义（P〉0．05）。结论飞利浦1．5T双梯度磁共振扫描仪可进行前列腺3D-^1H-MRS检查，且图像清晰，结果准确。

Objective To study the feasibility of three- dimensional 1H magnetic resonance spectroscopy （3D-^1H-MRS） imaging for benign and malignant prostatic diseases using Philips 1.5T dual- gradient magnetic resonance scanner （Philips Intera 1.5T Achieva Nova-Dual MR）. Methods The cardiac phase array coil and three-dimensional magnetic resonance spectroscopy （3D-MRS） brain software of Philips 1.5T dual-gradient magnetic resonance scanner （Holland） were used to detect the prostate in 12 healthy volunteers from April to July, 2008. Various imaging parameters of 3D-^1H-MRS were obtained. Thereafter, 3D-^1H-MRS detection was performed in 12 cases of clinicopathology-confirrned prostate cancers, 32 cases of biopsy- or laboratory-ldentified prostatitis and 24 cases of benign prostatic hyperplasia from July 2008 to January 2009. The results of 3D-^1H-MRS imaging on healthy volunteers and 68 cases of prostatic diseases were analyzed and compared. Results Clear 3D-^1H-MRS imaging of the prostate was obtained. In the MRS maps of prostate in various benign and malignant prostatic diseases and healthy volunteers, the chemical shift of the resonance choline （cho） peak was located at 3.25 ppm, creatin（cre） peak at 3.06 ppm, and citrate （cit） peak at 2.65 ppm. The maps of peripheral region in benign prostate diseases （prostatitis and prostatic hyperplasia） and normal prostate showed higher cho peak in close adjacency to a lower cre peak, and the highest cit peak. A highest cho peak, a lower cre peak and a significantly lowered cit peak were seen in the map of prostatic cancer. The ratios of （cho＋cre） over cit were 0.55±0.21, 4.02±1.96, 0.64±0.22 and 0.43± 0.14 in prostatitis, prostatic cancer, prostatic hyperplasia and normal prostate tissue respectively, with statistical difference between prostatic cancer and other types of prostatic tissues （P〈0.05）, but not among normal tissue, prostatitis and prostatic hyperplasia （P〉0.05）. Conclusion Philips 1.5T dual- gradient magnetic resonance scanner may be useful for 3D-^1H-MRS of the prostate which yields distinct pictures and accurate findings.