【摘要】 目的分析前列腺中央腺体癌、增生结节3.0 T MRI及磁共振波谱成像(MRS)表现征象,探讨MRS对两者鉴别诊断价值。方法回顾性分析经手术病理证实的11例前列腺中央腺体癌、21例增生结节患者的3.0 T MRI及MRS表现,比较中央腺体癌及增生结节MRI表现及(胆碱+肌酸)/枸橼酸盐[(Cho+Cre)/Cit]的比值。结果 MRI检查中央腺体癌11例均表现为中央腺体增大;2例中央腺体区信号不均,见不规则低信号;8例中央腺体区示低、稍高混杂信号结节;1例中央腺体区弥漫性低、等混杂信号结节,侵入外周带。增生结节21例均表现为中央腺体增大,与周围带分界清楚。21例共32个结节,其中25个结节表现为多个大小不等圆形、椭圆形,高、低、等混杂信号;5个以稍高信号为主类圆形结节,周围见低信号包膜。2个以低信号为主类圆形结节。MRS测得中央腺体癌区(Cho+Cre)/Cit值为2.75±1.34,范围1.12~5.67;增生结节组(Cho+Cre)/Cit值为0.70±0.28,范围0.21~1.16。两者差异有统计学意义(t=0.517,P<0.05)。结论前列腺中央腺体癌3.0 T MRI信号复杂多样,与增生结节相比,信号无特异性,常规MRI定性困难;中央腺体癌与增生结节3.0 T MRS有明显差异;3.0 T MRS能提供中央腺体癌的代谢信息,能更方便、更有效地诊断中央腺体癌。更多还原

【Abstract】 Objective To analyze the characteristics of 3.0 T MRS and MRI in prostatic central gland cancer and benign prostate hyperplasia. To evaluate the value of MRS in differential diagnosis of both. Methods 3.0 T MRI and MRS findings were reviewed retrospectively in 11 patients with pathologically-confirmed prostatic central gland cancer and 21 patients with benign prostate hyperplasia. The findings of MRI and the(choline+creatine)/citrate [(Cho+Cre)/Cit] ratio of both were compared. Results Enlargement of central grand was found in MRI of 11 cases with prostatic central gland cancer. In 2 cases, the signal in central grand was uneven and irregular low signal was found; In 8 cases, low-slight high mixed signal nodular lesions were found; In 1 case, diffuse low-equal mixed signal nodule was found invading peripheral zone. Enlargement of prostate gland was found in MRI of 21 cases with benign prostate hyperplasia and clear boundary with peripheral zone. 32 nodules were found in 21 cases. Among them, 25 nodules present the different size of circular, oval with high-low-equal mixed signal; 5 circular nodules mainly with slight high signal was around with low-signal envelope; 2 circular nodules were mainly low signal. The ratio of(Cho+Cre)/Cit and the range in central gland cancer and benign prostate hyperplasia regions were 2.75±1.34, 1.12-5.67 and 0.70±0.28, 0.21-1.16, respectively. The difference in ratio between the two groups was statistically significant(t=0.517, P<0.05). Conclusion 3.0 T MRI signal of prostatic central cancer is complicated and has no specificity compared with hyperplastic nodule. It is difficult to diagnose by the routine MRI. The characteristics of 3.0 T MRS of both are obviously different. 3.0 T MRS can provide the metabolic information of central gland cancer, can diagnose more conveniently and more effectively.更多还原