摘要
目的:探讨结合MRI和三维质子磁共振波谱成像(three dimension H-1magnetic resonance spectroscopy imaging,3D1H MRSI)对前列腺外周带良性病变的诊断和鉴别诊断的价值。方法:经病理和临床确诊的前列腺外周带良性病变16例,行盆腔MRI检查和3D1H MRSI定量分析。观察病灶形态与信号并计算病灶体积,在MRSI代谢图上测量其(胆碱+肌酸)/枸椽酸盐[(Cho+Cre)/Cit]的比值。并将结果与16例经系统穿刺活检确诊的前列腺癌进行对照。结果:1)良性病变多表现为结节状,边缘清楚(69%);前列腺癌多表现为片状,有结节感,边缘不清(56%),差异有统计学意义,χ2=12.74,P=0.002。2)良性病变的体积(1.96±1.92)mL,显著低于前列腺癌的(4.34±2.74)mL,t=2.68,P=0.013。3)良性病变与前列腺癌的信号均主要表现为T2WI,明显低于正常外周带,与闭孔内肌信号相近或稍高,T1WI与闭孔内肌相比多呈等信号。两组间T2WI和T1WI信号差异均无统计学意义,P值均>0.05。4)良性病变(Cho+Cre)/Cit的比值为0.68±0.17,显著低于前列腺癌的2.30±0.79,t=7.54,P=0.000。结论:前列腺外周带良性病变和前列腺癌的MRI信号相似,但两者在MRI形态、病灶体积和MRSI代谢方面均有差异,结合MRI和3D1H MRSI检查对前列腺外周带良性病变的诊断和鉴别诊断有重要意义。
OBJECTIVE： To investigate the value of MRI imaging and 3D ^1H MRSI in the diagnosis of benign disease of prostatic peripheral zone （PZ）. METHODS.. Sixteen cases of benign diseases of prostatic peripheral zone were all proved pathologically or clinically, and their MRI imaging and 3D ^1H MRSI were performed in each case. The shape, the volume and the signal intensity of the le sion were observed or measured on MRI imaging, and the corre sponding ratios of （Cho＋Cre）/Cit were calculated on the basis of the MRSI metabolic map. The results were compared with 16 cases of prostate cancer that were proved by pathology of systemic biop sy. RESULTS： 1）Most of benign lesion were nodular and well defined lesion （69%）, prostate cancer presented mainly as patch-like lesion with nodular feeling and ill-defined margin （56%）. The differences between the two groups were statistic ally significant, χ^2=12.74, P=0.002. 2）The average volume （1.96±1.92） mL of benign lesion was significantly less than that （4.34±2.74） mL of prostate cancer, t =2.68, P=0.013. 3）The signal intensitios of benign lesion and prostate cancer were less than that of normal PZ and were closed to or a little higher than that of inner obturatoria muscle on T2 weighted imaging, and presented as iso-intensity comparison with that of normal PZ on T1 weighted imaging. There was no statistic difference between the two groups, P〈0.05. 4）The average ratio （0.68±0.17） of （Cho＋Cre）/Cit of benign lesion was significantly less than that （ 2.30±0.79） of prostate cancer, t 7.54, P=0. 000. CONCLUSIONS： Although the signal intensities dif fere on MRI imaging between benign lesion of prostatic PZ and prostate cancer are similar, there are statistically differences of the shape, the volume on MRI imaging and metabolic levels measured by 3D ^1H MRSI between two groups. Combination of the results of MRI imaging and 3D ^1H MRSI will play an important role in the diagnosis of benign le sion of prostatic PZ.
出处
《中华肿瘤防治杂志》
CAS
2007年第21期1651-1655,共5页
Chinese Journal of Cancer Prevention and Treatment
基金
上海市卫生局资助项目(054080)
复旦大学附属肿瘤医院2003年院级基金资助
关键词
前列腺肿瘤/诊断
前列腺/良性病变
磁共振成像/波谱分析
诊断
鉴别
prostatic neoplasms/diagnosis
prostate/benign lesion
magnetic resonance imaging/spectroscopy
diagnosis, differentiation
