摘要
目的:探讨3.0T体线圈磁共振波谱对前列腺癌和前列腺增生的诊断和鉴别诊断价值。方法:分析经手术或穿刺活检证实的23例前列腺癌和34例前列腺增生的MRI、MRS所见。所有病例均应用3.0T MR体线圈行MR常规检查、扩散加权成像及MRS检查。MRS测量每个体素的枸橼酸盐(Cit)、胆碱(Cho)、肌酸(Cr)的相对值;(胆碱+肌酸)/枸橼酸盐[(Cho+Cr)/Cit]的比值。受试者工作特性曲线(ROC)下的面积值用来评价前列腺癌与前列腺增生鉴别的准确性,P<0.05表明有显著差异。分析病变区域的病理镜下所见。结果:前列腺癌患者癌体素的(Cho+Cr)/Cit平均值为3.49±2.05,增生体素的(Cho+Cr)/Cit平均值为1.19±0.71,两组间差异有显著统计学意义(t=12.755,P<0.01)。前列腺确定癌与增生前列腺组织的差别的ROC曲线下的面积(Az值)为0.863[95%可信区间为(0.818,0.907);P<0.01],当切点值为2.08时,Youden指数为0.547,诊断前列腺癌的敏感度为73.9%,特异度为88.5%。结论:3.0T体线圈MRS对前列腺癌和前列腺增生可以很好地鉴别诊断,可应用于临床诊断,指导临床医师穿刺检查。
Objective：To discuss the value of proton magnetic resonance spectroscopy （MRS） with body coil at 3.0T in differential diagnosis of the prostate cancer from prostatic hyperplasia. Methods： MRI and MRS at a 3.0T scanner were preoperatively performed in 23 patients with prostate cancer and 34 patients with prostatic hyperplasia, which were con- firmed either by surgery or by biopsy. All the patients underwent conventional MR imaging, the diffusion-weighted imaging （DWI） ,and MRS with body coils at a 3.0T MR scanner. The relative values of citrate,choline and creatine were measured, and the value of the choline plus creatine to-citrate （Cho±Cr/Cit） ratio was calculated for all voxels. Areas under the re- ceiver operating characteristic curves （Az） were used to assess the accuracy of discrimination of cancer from prostatic hy- perplasia tissues. P〈0.05 indicated a statistically significant difference. Results： Mean Cho＋Cr/Cit ratios for cancer tissues were 3.49±2.05,1.19±0.71 for hyperplasia tissues;they were significantly different （t= 12. 755,P（0.01）. Az for dis- crimination of definite cancer tissue from hyperplasia tissue was 0. 863 [95 % confidence interval of the difference （0. 818, 0. 907） ,P〈0. 01] ,and the optimal threshold for the diagnosis of prostate cancer was 2.08 with a sensitivity of 73.9% and a specificity of 88.5%. Conclusion：MRS with body coil at 3.0T can discriminate cancer from prostatic hyperplasia, so it can be applied to diagnosis or biopsy guidance for prostate disease.
出处
《放射学实践》
2013年第6期673-677,共5页
Radiologic Practice
关键词
前列腺肿瘤
癌
前列腺增生
病理学
磁共振波谱学
Prostatic neoplasms
Carcinoma
Prostatic hyperplasia
Pathology
Magnetic resonance spectroscopy
