3.0T MR波谱成像与扩散结合在前列腺中央腺体癌诊断中的价值

Value of 3.0T MR Spectroscopy Combined with Diffusion Weighted Imaging in Prostatic Central Gland Cancer Diagnosis

目的:探讨3.0T磁共振波谱成像(MRSI)结合扩散加权成像(DWI)在前列腺中央腺体癌中的诊断价值。方法:回顾性分析术前MRSI与DWI结合诊断为前列腺中央腺体癌的患者共18例,术后确诊为前列腺癌16例、前列增生1例、前列腺增生伴前列腺中度到重度炎症1例。其中3例已经确诊中央腺体癌为激素治疗后行MRI检查。比较患者癌区与对侧非癌区两组间的(胆碱+肌酸)/枸橼酸盐(CC/C)值。结果:无任何治疗的13例中央腺体癌区158个体素的CC/C值均值为2.684±1.7,非癌区196个体素的CC/C均值为0.49±0.08。(T值为2.778,P值均=0.017<0.05),中央腺体癌区与对侧非癌区之间的CC/C值差异有统计学意义。3例激素去势治疗后癌区的CC/C均值为1.18±0.95,非癌区22个体素CC/C均值为0.46±0.255。(T值为1.196,P值均=0.354>0.05)。激素治疗后中央腺体癌区与对侧非癌区之间的CC/C值差异无统计学意义。结论:MRSI结合DWI显著提高前列腺中央腺体癌的诊断。

Objective： To discuss the value of 3.0T MR spectroscopic imaging（MRSI） combined with diffusion-weighted imaging（DWI） in detecting the prostatic central gland cancer. Methods： The clinical and MR imaging data of 18 patients were analyzed retrospectively, here were 16 cases suffered from prostatic central gland cancer after surgery, 1 case suffered from prostate hyperplasia,and 1 case suffered from prostate hyperplasia and inflammation from mid to high level. 3 cases among the 16 cancer had been treated with hormone before MRI. CC/C values of patients＇ cancerous zone and non-cancerous zone were compared. Results： In the prostatic central gland cancer zone, the 158 voxels＇ CC/C average value of the 13 cases without any treatment is 2.684±1.7, however, the CC/C average of 196 voxels is only 0.49±0. 08 in the non-cancerous zone, which has statistically significant difference between the CC/C value of the prostatic central gland cancer and non-cancer zone without any treatment（T values were 2.778, P values =0.017〈 0.05）. As for the 3 cases, which took the hormone therapy, heir 44 voxels＇ CC/C average value of cancerous zone is 1.18 ±0. 95, and the 22voxels＇ CC/C average value of non-cancerous zone is 0.46±0. 255, which has no statistically significant difference between the CC/C value of the prostatic central gland cancer and non-cancer zone after treated of hormone（T values were1.196, P values=0.354〈 0.05）.Conclusion： MRSI combined with DWI significantly improve the central gland prostate cancer diagnosis.