MRI、MRS对前列腺癌及前列腺增生的诊断价值

The diagnosis of MRI and MRS for prostate cancer and benign prostate hyperplasia

目的探讨MRI、MRS在前列腺癌及前列腺增生诊断中的应用。方法回顾性分析经病理证实的28例前列腺癌和32例前列腺增生患者的MRI前列腺形态、信号改变及MRS测量枸橼酸盐(Citrate)、胆碱(Choline)、肌酸(Creatine)的峰值、(胆碱+肌酸)/枸橼酸盐[(Cho+Cre)/Cit,CC/C]的比值。结果 MRS测得PCa癌区和BPH中央带的CC/C平均值分别为(2.24±0.96)和(0.67±0.21),组间差异有统计学意义(t=3.989,P<0.001)。28例前列腺癌患者MRI确诊为前列腺癌21例,准确率75%;MRI联合MRS确诊为前列腺癌26例,准确率为92.9%。32例BPH患者MRI影像诊断确诊为前列腺增生23例,不除外前列腺癌9例,准确率为71.9%。MRS波谱分析结合MRI影像诊断确诊为前列腺增生29例,不除外前列腺癌3例,准确率为90.6%。结论 MRI能很好地显示BPH和PCa的形态和信号特点,MRS能提供前列腺良、恶性组织的代谢信息,两者联合诊断有助于提高PCa和BPH的诊断的准确性。

Objective To explore the application of MRI and MRS techniques in the diagnosis of prostate cancer and benign prostate hyperplasia. Methods 28 patients with prostate cancer and 32 patients with benign prostate hyperplasia were studied. All cases were proved histopathologically. Through studying all cases＇ MRI morphology and MR signal changes, a ret- rospective analysis was made . MRS observations included the chemical shift of citrate （Cit）, choline （Cho） and creatine （Cre） spectra, and the ratio of （ Cho ＋ Cre）/Cir. Results The average ratio of CC/C for prostate cancer （2.24 ± 0.96 ） was statistically higher than that of the regions of B PH （0. 67 ± 0. 21 ） （ t = 3. 989,P 〈 0. 001 ）. In cancer group,21 cases could be diagnosed as prostate cancer by MRI, the rate of correct diagnosis was 75 % ;MRI plus MRS examination diagnosed 26 cases as prostate cancer, the rate of correct diagnosis was 92.9%. In BPH group ,23 cases could be exactly diagnosed as BPH ,9 cases could not be differentiated between PCa and BPH. The rate of correct diagnosis was 71.9% ; MRI plus MRS examination could get exact diagnosis in 29 cases as BPH,the rate of correct diagnosis was 90. 6%. Conclusion MRI can well reveal the morphology and signal features of BPH and PCa. MRS can provide the metabolic information of benign and malignant tissue. The combination of MRI and MRS is useful in the diagnostic accuracy of BPH and PCa.