【作者】 秦伟；

【导师】 储成凤；

【作者基本信息】 东南大学 ， 影像医学与核医学， 2005， 硕士

【摘要】 目的:评价脊柱表面线圈及MRI、1HMRS在前列腺癌诊断中的价值。材料与方法:对正常前列腺志愿者48例、前列腺疾病患者68例,分别用脊柱表面线圈、腹部包裹相控阵线圈进行MRI及MRS检查。对两种线圈扫描所得到的轴位压脂T2WI图像进行质量评价和PCa诊断试验评价,对MRS数据进行PCa诊断试验评价。所有数据使用SPSS11.5软件包进行统计学分析。结果:68例前列腺疾病患者中,最后诊断PCa 36例、BPH 24例、前列腺炎8例。以T2WI像低信号作为PCa的MRI诊断标准进行诊断试验的敏感性为80.6%,特异性为92.5%,符合率为88.8%,约登指数为0.7,阳性预测值为82.9%,阴性预测值为91.4%。以(Cho+Cre)/Cit =0.93为PCa的MRS诊断界值进行诊断试验的敏感性为94.4%,特异性为92.5%,符合率为93.1%,约登指数为0.87,阳性预测值为85.0%,阴性预测值为97.4%。MRI及MRS联合串联试验的灵敏度为76.1%,特异度为99.4%,约登指数为0.67,联合并联试验的灵敏度为98.9%,特异度为85.6%,约登指数为0.85。PCa组(Cho+Cre)/Cit比值为2.38(2.06,2.71),正常前列腺组为0.59(0.55,0.62),BPH组为0.72(0.59,0.85) ,前列腺炎组为0.47(0.37,0.59)。正常前列腺外周带(Cho+Cre)/Cit比值为0.49(0.44,0.53),中央带为0.69(0.65,0.72)。正常前列腺外周带(Cho+Cre)/Cit比值的95%正常参考值范围为0.49±0.31,中央带为0.69±0.25。两种线圈扫描所得轴位压脂T2WI图像质量未见统计学差别。结论:1. MRI在PCa的诊断中有较高的诊断价值,MRS有很高的价值,二者联合应用有更高的诊断价值。2. PCa的(Cho+Cre)/Cit比值明显高于正常前列腺、BPH和前列腺炎。正常前列腺外周带的(Cho+Cre)/Cit比值小于中央带。正常前列腺不同年龄层之间、PCa不同Gleason分级分期间及BPH不同I-PPS评分增生程度间的(Cho+Cre)/Cit比值无差别。3.脊柱表面线圈在前列腺的磁共振成像中有很高的实用价值。更多还原

【Abstract】 Objective: To evaluate the value of spine surface coil, MRI and 1HMRS for prostatic carcinoma diagnosis.Materials and Methods: Forty-eight normal volunteers and 68 patients with disease of prostatic experienced MRI and 1HMRS, respectively, with spine surface coil and abdomen phased-array coil. For all the axial fat-saturation T2WI imaging, quality evaluation was performed. Diagnostic test of PCa was evaluated for whole scaned images and MRS datas. Statistics analysis was run with SPSS 11.5.Results: Final diagnoses were determined in 36 PCa, 24 BPH and 8 prostatitis, respectively. The sensitivity, specificity, coincidence rate, Youden’s index, positive predictive value and negative predictive value of diagnostic test are 80.6%, 92.5%, 88.8%, 0.7, 82.9%, 91.4% with MRI and 94.4%, 92.5%, 93.1%, 0.87, 85%, 97.4% with MRS, respectively. While, The sensitivity, specificity, and Youden’s index are 76.1%, 99.4%, 0.67, in serial tests and 98.9%, 85.6%, 0.85 in parallel tests. The ratios of (Cho+Cre)/Cit with PCa, normal’s, BPH, and prostatitis, prostatic periphery zone and central zone are 2.38(2.06,2.71), 0.59(0.55,0.62), 0.72(0.59,0.85), 0.47(0.37,0.59), 0.49(0.44,0.53), 0.69(0.65,0.72), respectively. 95% reference ranges of (Cho+Cre)/Cit with prostatic periphery zone and central zone are 0.49±0.31 and 0.69±0.25. There are no significant differences of axial fat-saturation T2WI image quality between spine surface coil and abdomen phased-array coil (P>0.05).Conclusion: MRI is important in diagnosis of prostatic carcinoma and MRS is more valuable. The ratios of (Cho+Cre)/Cit with PCa is the highest in all groups, PCa, normal’s, BPH, and prostatitis. While, prostatic periphery zone’s ratios is lower than central zone’s. There are no significant differences of the (Cho+Cre)/Cit among different ages of normal’s, different gradings of PCa, and different hyperplasia degrees of BPH. It is high utility value for the spine surface coil in the prostate MR imaging.更多还原