摘要
目的探讨动脉自旋标记技术（ASL）、磁共振波谱成像（MRS）联合血清前列腺特异抗原（PSA）诊断前列腺癌（PCa）和良性前列腺增生（BPH）的价值。方法收集44例患者行常规MRI、ASL及MRS检查，均获得PSA数据，其中经穿刺活检或手术病理证实为PCa的患者20例，BPH患者24例。在常规上观察前列腺的形态、病变位置、信号特点及肿瘤侵犯范围。ASL上结合常规MRI测量病灶的灌注改变。MRS上测量胆碱＋肌酸（Cho＋Cre）／枸椽酸盐（Cit）比值（CC／C）。结果20例PCa，18例位于周围带（PZ），其中4例同时累及PZ和CG，5例累及对侧，另2例仅位于中央腺体（CG），T_2WI表现为结节状或片状低信号；17例DWI呈高信号，3例呈等信号，T_1WI呈等、低信号；9例包膜完整，11例突破包膜。24例BPH，23例位于中央带及移行带，前列腺的外形增大，压迫膀胱颈，1例位于PZ；T_2WI图像上8例表现为弥漫性混杂信号，14例表现为大小不等的圆形或结节状高信号，2例以低信号改变为主，DWI呈等或稍高信号，包膜完整，周围带受压变薄。T_2WI诊断标准，20例PCa患者平均评分为（3．70±1．13）分，24例BPH患者平均评分为（1．96±0．91）ml／（100g·min），两者间差异有统计学意义（P=0．00）。MRS检查20例PCa患者病灶（CC）／C比值明显升高，为（2．09±0．85），24例BPH患者病灶（CC）／C比值为（1．02±1．05），二者间比值有显著差异（P=0．001）。ASL检查20例PCa患者病灶的平均灌注值为（130．97±37．6）ml／（100g·min）；非肿瘤区的平均灌注值为（78．30±13．3）ml／（100g·min），两者有显著性差异（P=0．00），PCa病灶灌注明显增高。24例BPH的平均灌注值为（89．1±24．8），与PCa患者病灶间有统计学差异（P=0．00），BPH的灌注较PCa病灶低。PSA数据显示20例PCa的PSA范围是8~1119．2ng／ml，其〉10ng／ml者17例，〈1O
Objective To investigate the diagnosis value of the combination of arterial spin labeling （ ASL ） , magnetic resonance spectroscopy （ MRS ） and prostate specfic antigen （ PSA ） on prostate cancer （ PCa ） and benign prostatic hyperplasia （ BPH ） . Methods Forty-four patients were collected with conventional MRI, ASL and MRS examinatiom, and all of them obtained PSA data, including 20 patients with PCa and 24 patients with BPH , which were confirmed by needle biopsy, surgical pathology. Results Among 20 patients with PCa, the lesiom of 18 patients were located in the peripheral zone （ PZ ） while the other 2 patients had lesions in the central gland （ CG ） . Besides, 4 patients lesions were both in PZ and CG and 5 were on the contralateral side. Nodular or flaky low-intensity signals were showed on T_2WI. On DWI, 17 cases showed high-intensity signals while the other 3 showed low-intensity signals. Iso- or low-intensity signals were presented on T_1WI. 9 cases had complete capsule and capsule breakage occurred on 11 cases. Among 24 cases of patient with BHP, the lesions of 23 patients were located in the central zone and transition zone and their appearances ofprnstate were enlarged which made the bladder neck be oppressed. The other 1 patient had lesions in PZ. On the T_2WI images, 8 cases showed diffuse mixed signals, 14 cases presented different size of circular or nodular high-intensity signals and 2 cases mainly showed low signal changes. Iso- or slightly high-intensity signals were presented on DWI. The 24 patients had complete capsule and the PZ became thin because of the compression. 20 patients with PCa scored an average of （ 3.7 ± 1.13 ） while 24 patients with BPH had an average value of （ 1.96 ± 0.91 ） with the diagnostic criteria of T2WI images. There was a statistical difference （P=0.00） between the two groups. The results of MRS revealed CC/C ratio of the lesions of the 20 patients with PCa increased significantly and had a value of （ 2.09 ± 0.85 ） . The C
出处
《浙江临床医学》
2018年第6期1017-1020,共4页
Zhejiang Clinical Medical Journal
关键词
前列腺癌
前列腺增生
磁共振波谱
前列腺特异抗原
动脉自旋标记技术
Prostate cancer
Benign prostatic hyperplasia
Magnetic resonance spectroscopy
Prostate specific antigen
Arterial spin labeling
