MRI平扫联合应用DWI、MRS、DCE-MRI对前列腺病变诊断价值的研究

MR scan Combination of Functional MRI(fMRI) and Diffusion Weihted Imaging(DWI)and MR Spectroscopic Imaging(MRS) and Dynamic Contrast-enhanced MRI,(DCE-MRI)on the Diagnostic Value of Prostate Disease

目的探究MRI平扫联合应用DWI、MRS、DCE-MRI对前列腺病变的诊断价值。方法对47-85岁中老年男性153例行常规磁共振检查,其中正常前列腺病人联合弥散加权像、波谱分析,疑诊前列腺癌和增生病人联合DWI、MRS及DCE-MRI检查,后行DWI和MRS分析,绘制DCE-MRI感兴趣区时间-信号曲线。统计分析正常前列腺生物学行为、代谢产物特征,前列腺癌和前列腺增生两种病变生物学行为、代谢产物胆碱(Cho)、枸橼酸盐(Cit)、肌酸(Cre)的峰值特征及(Cho+Cre)/Cit均值的比较,以及动态增强分析增生和癌变血液动力学特征,用独立样本t检验,P<0.05认为差异具有统计学意义。最后MRI诊断为前列腺增生和前列腺癌的病例进行穿刺或电切活检比较两者的符合率。结果 30例正常前列腺中央区T1WI呈等或稍高信号、外周带T1WI呈均匀中等或略偏低信号,T2WI中央区呈中等信号,外周带呈新月形高信号,DWI正常前列腺中央区、外周带信号无显著差异。正常前列腺中央腺区、前列腺增生、前列腺癌之间ADC值差异有统计学意义(P<0.05),正常前列腺外周带与前列腺增生之间ADC值差异无统计学意义(P>0.05)。正常前列腺外周带与增生病变代谢产物峰值比无显著差异(P>0.05),前列腺增生与前列腺癌代谢产物峰值比值具有显著差异(P<0.05)。结论 MRI平扫T2WI对前列腺病变显示敏感性高、特异性低,DCE-MRI、DWI和MRS三种检查方法在前列腺癌诊断中具各具有特征性表现,平扫联合功能成像DWI、MRS、DCE-MRI可较大程度提高病变诊断的敏感性、特异性甚至定量诊断。

Objective Application of magnetic resonance imaging （MRI） scan in combination with a varieW of functional imaging of normal prostate, prostate cancer and prostate hyperplasia patients for biological behaviour, metabolic product characteristics and dynamic enhancement time-signal curve for this paper. Methods Selected age 47-85, 153 cases of elderly men patients in the conventional magnetic resonance imaging. Normal prostate patients combined diffusion weighted image can, 3D1H-MR spectroscopy. Suspected diagnosis of patients with hyperplasia of prostate and joint DW1, MRS and DCE-MP, I, DWI and MRS can after analysis, Draw the DCE-MP, I mearn curve areas of interest. Statistical analysis of normal prostate biological behavior characteristics. metabolites, Hyperplasia of prostate and prostate two lesions choline （Cho）biological behaviour, metabolites,citrate salt（Cit）, characteristics ofcreatine（Cre） and peak（Cho＋Cre）/ Cit the comparison of the mean, Dynamic enhanced nodule henlodynamic characteristics analysis of hyperplastic nodule and cancer,With independent samples t test, P〈0.05 think the difference is statistically significant.The MRI diagnosis of prostatic hyperplasia and prostate cancer cases biopsy or cutting biopsy compared the coincidence rate. Results cases of normal prostate central T1WI, or slightly high signal, the peripheral zone TIWI homogeneously middle or slightly low signal,T2WI central moderate signals, Peripheral zone crescent high signal, DWI nonnal central and peripheral zone of prostate can signal no significant difference. Normal prostate central, prostate hyperplasia, prostate gland area between ADC values difference was statistically significant（P〈0.05）,Nonnal prostate peripheral zone and ADC values differences between prostatic hyperplasia has no statistical significance （P〉0.05）. The hyperplasia and normal prostate peripheral zone lesions metabolites peak than there was no significant difference （P〉0.（}5）, prostatic hyperplasia and prostate cancer metabolites peak ratio has significant difference （P〈0.05）.Conclusion MRI scan T2WI of prostate lesions showed low sensitiviW, high specificity, DCEMRI, DWI and MRS can three inspection methods in the diagnosis of prostate cancer with the characteristic, .joint fnnction imaging DWI, MRS, DCE can scan, MRI can largely improve lesions diagnostic sensitivity, specificity, and even the quantitative diagnosis.