磁共振波谱成像在前列腺癌诊断中的应用价值

The application value of magnetic resonance spectroscopy in diagnosis for prostate cancer

目的评价磁共振波谱成像(MRS)在前列腺癌(PCa)诊断中的应用价值,并探讨MRS在PCa诊断中的优势及不足。方法对62例临床疑为PCa患者进行T2WI、弥散加权成像(DWI)和MRS检查,最终经穿刺活检或手术病理证实,41例为PCa,15例为良性前列腺增生(BPH),6例为前列腺炎。分析所有患者穿刺或手术前MRI影像资料,计算枸橼酸盐(Cit)、胆碱(Cho)、肌酸(Cre)的含量以及Cho+Cre与Cit的比值(CC/C),并以CC/C≥0.86为PCa阳性的诊断标准。与病理结果相对照,计算并比较T2WI+DWI与MRS诊断PCa的敏感度和特异度。结果 T2WI+DWI准确诊断出41例PCa中的38例,漏诊3例,敏感度为92.68%,特异度为80.95%。MRS准确诊断出41例PCa中的36例,漏诊5例,敏感度为87.80%,特异度为71.42%。结论 MRS在PCa诊断中具有一定的价值,但其仍存在一些不足,联合应用T2WI、DWI及MRS检查可望进一步提高PCa诊断的敏感度和特异度。

Objective To evaluate the application value of magnetic resonance spectroscopy(MRS)in the diagnosis of prostate cancer(PCa),and to explore the advantages and disadvantages of MRS in the diagnosis of PCa.Methods Sixty-two patients who were suspect PCa were scanned by T2 WI,diffusion weighted imaging(DWI)and MRS.All of them confirmed by biopsy or operative pathology,forty-one cases with PCa,fifteen cases with benign prostatic hyperplasia(BPH)and six cases with prostatitis.All patients were analyzed with MRI images datum before puncture or operation.The contents of citrate(Cit),choline(Cho),creatine(Cre)and the ratio of Cho+Cre and Cit(CC/C)was calculated.The diagnostic criteria of PCa positive was CC/C≥0.86.Contrasted with the pathological results,the diagnostic sensitivity and specificity were calculated and compared between the T2 WI+DWI and MRS in the diagnosis of PCa.Results In forty-one cases with PCa,thirty-eight cases were confirmed rightly by the T2 WI and DWI,three cases were missed diagnosis,and the diagnostic sensitivity and specificity of the T2 WI and DWI were92.68%,80.95%.Thirty-six cases were confirmed rightly by MRS,five cases were missed diagnosis,and the diagnostic sensitivity and specificity of MRS were 87.80%,71.42%.Conclusion MRS is helpful in the diagnosis of PCa,but it has the shortages.The combination of T2 WI,DWI and MRS can improve the diagnostic sensitivity and specificity for the detection of PCa.