T2WI与磁共振波谱成像联合用于临床前列腺癌鉴别诊断的价值

The application of T_2-weighted imaging combined with proton magnetic resonance spectroscopic imaging on prostate cancer detection

目的探讨T_2加权成像(T_2-weighted imaging,T_2WI)联合磁共振波谱成像(magnetic resonance spectrocopy,MRS)运用在前列腺癌(prostate carcinoma,PCa)临床鉴别诊断中的价值。方法选取本院于2014年1月至2016年1月期间收治的80例行磁共振成像(magnetic resonance imaging,MRI)检查并经穿刺活检确诊的PCa患者,所有患者均行T_2WI和MRS扫描,并在MRI检查后进行病理组织学诊断,比较T_2WI、MRS和T_2WI联合MRS诊断PCa的诊断效能。结果 PCa病灶T_2WI表现为边界模糊,片状或结节状或均质低信号,MRS表现为胆碱(Cho)峰升高,枸橼酸盐(Cit)峰下降,两者波峰倒置,局部3个相邻体素Cho/Cit高于1;前列腺增生(benign prostatic hyperplasia,BPH)病灶T_2WI呈斑片状高低混杂影或均匀等/高信号,MRS表现为Cit峰升高,Cho、Cre(肌酸)峰相对降低或升高。MRS、T_2WI联合MRS诊断PCa的灵敏度、特异度和准确度显著高于T_2WI(P<0.05);T_2WI联合MRS的ROC曲线下面积显著高于T_2WI和MRS,差异具有显著性(P<0.05);PCa患者(Cho+Cr)/Cit、Cho/Cit比值显著高于BPH患者(P<0.05)。结论 T_2WI和MRS均可独立用于PCa的鉴别诊断,但联合应用的敏感性和准确性显著提高,诊断效能更好。

Objective To explore the application of T2-weighted imaging combined with proton magnetic resonance spectroscopic imaging on prostate carcinoma detection. Method The hospital in January 2014 to 2016 years during routine magnetic resonance imaging （MRI） examination admitted 80 patients and by biopsy diagnosed PCa underwent conventional T2-weighted imaging （T2WI） and magnetic resonance spectroscopic （MRS） imaging scan and MRI examination after histopathological diagnosis, more T2WI, T2WI MRS and MRS joint diagnosis of PCa diagnosis performance. Result PCa patients T2WI showed fuzzy boundaries, flake or nodular or homogeneous low signal, MRS showed elevated Cho peak, Cit peak decline, both peak inversion, partial three adjacent voxels Cho/Cit greater than 1; benign prostatic hyperplasia （BPH） patients T2WI showed patchy level of uniform or mixed Movies/high signal, MRS showed Cit peak rises, Cho, Cre peak relatively lowered or raised. MRS, MRS T2WI joint diagnosis of prostate cancer sensitivity, specificity, accuracy were significantly higher than T2WI （P〈0.05）; the area under the ROC curve TzWI joint MRS significantly higher than T2WI and MRS the difference was statistically significant （P〈0.05）; PCa patients （Cho ＋ Cr） / Cit, Cho / Cit ratio was significantly higher in patients with BPH （P〈0.05）. Conclusion T2WI and MRS can be used independently for PCa diagnosis, but the sensitivity and accuracy combined with significantly improved diagnostic performance better.