MRS及DWI成像对早期前列腺癌的诊断价值

Value of MRS and MR imaging in the diagnostic of early prostate cancer

目的探讨磁共振波谱分析(MRS)和弥散成像(DWI)对早期前列腺癌的诊断价值。方法选取我院2012年1月至2013年12月经病理证实的前列癌腺癌和良性前列腺增生患者各30例,均行MRS和DWI,同时选择同期前列腺炎患者30例作为前列腺炎组,对ADC值、(Cho+Cre)/Cit值及与病理诊断符合率进行比较。结果在扩散敏感度系数b=600 s/mm2、b=800 s/mm2时,前列腺癌组ADC值明显低于良性前列腺增生组和前列腺炎组,差异具有统计学意义(P<0.05)。前列腺癌组(Cho+Cre)/Cit值明显高于良性前列腺增生组和前列腺炎组,差异具有统计学意义(P<0.05)。MRS检查阳性26例,与病理检查符合率为86.55%,DWI检查阳性25例,与病理检查符合率为83.33%,MRS和DWI联合检查阳性29例,与病理检查符合率为96.67%,检出率明显提高。结论因前列腺癌组织微观结构和代谢水平关系密切,因此有必要采用MRS和弥散成像联合检测,以提高早期诊断准确率。

Objective To explore the value of resonance spectroscopy （MRS） and diffusion imaging （DWI） in the diagnosis of early prostate cancer. Methods From January 2012 to December 2013, 30 patients with prostate cancer and 30 patients with benign hyperplasia of prostate gland carcinoma, which were pathologically proved, were chosen as study objects. Both MRS and DWI were used in those patients. At the same period, 30 patients with prostatitis were chosen as prostatitis group. The ADC values, （Cho＋cre）/cit value and its coincidence rate with the pathological diagnosis were compared. Results When the sensitivity in the diffusion coefficient was b=600 s/mm^2 or b=800 s/mm^2, the ADC values in prostate cancer group was significantly lower than those in benign prostatic hyperplasia and prostatitis group with significant differences （P〈0.05）. The （Cho＋cre）/cit value in prostate cancer group was significantly higher than those in benign prostatic hyperplasia and prostatitis group with significant differences （P〈0.05）. 26 patients were positive detected by MRS, and the coincidence rate with pathologic examination was 86.55%. 25 patients were positive detected by DWI, and the coincidence rate with pathological examination was 83.33%. 29 cases were positive detected by MRS and DWI joint inspection, and the coincidence rate with pathologic examination was 96.67%. The detection rate was significantly improved. Conclusion Due to the microstructure of prostate cancer tissues and its close relationship to metabolism, it is necessary to adopt MRS combined with DWI to improve the accuracy of early diagnosis.