磁共振波谱成像对前列腺癌诊断价值的研究

Value of magnetic resonance spectroscopy in diagnosis of prostate cancer

目的 探讨磁共振波谱（MRS）在前列腺癌及良性前列腺增生诊断中的价值.方法 回顾性分析经病理证实的55例（良性前列腺增生36例,前列腺癌19例）患者的临床资料、磁共振成像（MRI）和MRS所见.检测代谢产物包括枸橼梭盐（Cit）、胆碱复合物（Cho）、肌酸（Cre）的波谱图.MRI观察前列腺的大小、信号特点、病变位置及肿瘤侵犯程度.MRS观察Cit、Cho、Cre的峰值及（Cho＋Cre）/Cit.结果 MRI对前列腺癌诊断的灵敏度、特异度、准确率分别为78.9%（15/19）、66.7%（24/36）、70.9%（39/5）.MRI＋MRS分别为84.2%（16/19）、88.9%（32/36）、87.3%（48/55）. MRI与MRI＋MRS两种方法在诊断前列腺癌的灵敏度、特异度、准确率方面差异均有统计学意义（P〈0.05）.结论 无创的MRS可以提示病变部位的代谢及其成分的改变,结合影像学表现有助于对良性前列腺增生和前列腺癌的鉴别诊断.

Objective To evaluate the value of magnetic resonance spectroscopy （MRS） in the diagnosis of prostate cancer and benign prostate hyperplasia. Methods Fifty-five patients including 36 benign prostate hyperplasia patients and 19 prostate cancer patients,were performed with the scanning of magnetic resonance imaging （MRI） and MRS. MRI observation was focused on the size of the gland,the signal features, the location of the lesion and the extent of the tumor. MRS observation included the chemical shift of citrate（Cit）, choline（Cho） and creatine（Cre） spectra, and the ratio of （Cho ＋ Cre） /Cit SPSS 13.0 statistical analysis software was performed for statistic analysis of MRI,MRI ＋ MRS in the diagnosis of prostate cancer to get the sensitivity,specificity and accuracy, respectively. Results Based on the analysis of MRI of prostate cancer and pathological findings, the diagnostic sensitivity,specificity and accuracy of MRI were 78.9%（ 15/19）,66.7%（24/36）,70.9%（39/55）, respectively. The diagnostic sensitivity,specificity and accuracy of MRI ＋ MRS were 84.2%（16/19）,88.9%（32/36）,87.3%（48/55）,respectively. There was significant difference between the two methods （P〈0.05）. Conclusions MRS has made it possible to obtain functional and metabolic information about prostate cancer non-invasively. Combining MRI and MRS are useful for differentiating diagnosis of benign prostate hyperplasia from prostate cancer.