【摘要】 目的:评价三维磁共振波谱成像(Three dimensional MR spectroscopic imaging,3D-MRSI)在MRI基础上联合应用对前列腺癌(PCa)和BPH的鉴别价值。方法:对37例疑为PCa的患者行MRI和3D-MRS检查,然后作10点或12点前列腺穿刺病理学检查,并将3D-MRS检查结果与病理检查结果进行对照。结果:穿刺病理检查结果证实,37例患者中,BPH13例,PCa24例。BPH的枸橼酸盐(Citrate,Cit)峰位于2.6ppm,胆碱峰值位于3.2ppm,特征表现为Cit/Cho比值升高;PCa患者MRI+3D-MRSI提示"PCa可疑"或"PCa"者共19例,符合度为79.2%,3D-MRSI特征为Cit峰明显降低,Cho峰显著升高,Cit/Cho比值降低。BPH组与PCa组Cit/Cho比值差异有统计学意义(P<0.05)。结论:不配备直肠线圈的情形下,结合MRI的3D-MRSI检查对于前列腺良恶性肿瘤的患者可得到有诊断意义的波谱信息。病理对照研究显示3D-MRSI有助于鉴别肿瘤与其他疾病,与MRI结合能直观地显示肿瘤范围。更多还原

【Abstract】 Objective:To evaluate the ability and value of in vivo three dimension MR spectroscopic imaging for distinguishing prostate carcinoma (PCa) and benign prostate hyperplasia (BPH). Methods: Combined phased array, MR imaging and 3D-MRSI was performed in 37 patients who were suspected with prostatic adenocarcinoma. MR imaging and 3D-MRSI data were compared with histopathological findings, after 10 or 12 dots biopsy pathological examination. Results: We employed seimense sonata 1.5 tesla scanner, without using endorectal coil. Pathological samples were obtained from all the patients, twenty-four of the 37 patients were identified with the prostatic adenocarcinoma, whereas the other thirteen were confirmed as benign prostate hyperplasia. Significant variations in metabolite levels with BPH and prostate cancer were detected with a 3D-MRSI examination added to a clinical MR imaging examination. In the result s of prostate hyperplasia, the peak value of Citrate (Cit ) is in 2.6 ppm; BPH was characteristic with an increased Cit/Cho ratio in 3D-MRS imaging. MRSI reported 19"PCa suspected"or"PCa" in all 24 PCa cases, corresponding rate was 79.2%, characteristic appearance of PCa was a significantly decreased Cit/Cho ratio. The changes of Cit/Cho ratio between BPH and PCa have statistically significant difference(P=0.0315,<0.05). Conclusions: 3D-MRSI can get significative spectrum and be useful to distinguish prostate cancer and prostate hyperplasia with pathologic comparison, even without employing endorectal coils. It also can display the area of cancer combined with MRI directly.更多还原