前列腺癌磁共振动态增强联合波谱成像的诊断价值

目的分析前列腺癌的磁共振波谱成像(~1H-MRS)及动态增强磁共振成像(DCE-MRI)表现,探讨~1H-MRS及DCE对前列腺癌的诊断价值。方法回顾性分析26例前列腺癌(Pca)及32例前列腺增生(BHP)的MR征象,全部患者行MRS及DCE检查,分析病例的MRS及DCE图像,测量Pca及BHP的(Cho+Cr)/Cit值。DCE共采集37次图像,分析Pca及BHP的SI-T曲线变化规律。结果在DCE-MRI检查中前列腺癌都表现为比正常的前列腺组织明显早期强化,26例PCa病人SI-T曲线24例表现为III型,2例表现为II型曲线,32例BPH病人SI-T曲线16例表现为I型曲线,8例表现为II型曲线,8例表现为III型曲线,DCE-MRI诊断的敏感性、特异性及准确率分别能达到92%、75%,82%;Pca患者中有4例(Cho+Cr)/Cit0.99,22例(Cho+Cr)/Cit0.99,BPH组有8例(Cho+Cr)/Cit0.99,24例(Cho+Cr)/Cit0.99,MRS诊断的敏感性、特异性及准确率分别能达到85%、89.1%,86%。结论 DCE-MRI对Pca敏感度较高,特异度较低,而~1H-MRS对Pca敏感性较低,联合~1H-MRS的量化指标与DCEMRI图像表现的SI-T曲线可提高前列腺癌诊断的正确率,并且可以直观显示病变部位、范围及转移情况,结合常规MRI对Pca进行准确的诊断和分期评估。

The Diagnostic Value of the Combined Spectra was Enhanced by Magnetic Resonance Imaging of Prostate Cancer

Objective To analyze the magnetic resonance spectrum imaging of prostate cancer (1H-MRS) and dynamic enhanced magnetic resonance imaging (DCE-MRI) performance, and explore the value to the diagnosis of prostate cancer.Methods A retrospective analysis of 26 cases of prostatic carcinoma (Pca) and 32 cases of hyperplasia of prostate (BHP) signs of MR, MRS and DCE examination, all patients analyzed cases of MRS and DCE image, Pca and BHP (Cho+Cr)/Cit value.DCE collect altogether 37 image, the analysis of Pca and BHP SI-T curve change rule.Results In DCE-MRI in prostate cancer are characterized by strengthening early than in normal prostate tissue, 26 patients with PCa SI -T curve of 24 cases of type III, 2 case of type II, 32 cases of BPH patients SI-T curve 16 cases of type I, 8 cases of II type, 8 cases of type III, DCE MRI diagnostic sensitivity, specificity and accuracy were 92%, 75%, 82%,4 cases of patients with Pca Cr (Cho)/Cit < 0.99, 22 cases (Cho + Cr)/Cit>0.99, BPH group has 8 cases (Cho + Cr)/Cit > 0.99, 24 cases (Cho + Cr)/Cit<0.99, MRS diagnostic sensitivity, specificity and accuracy were 85%, 89%, 86%.Conclusion MRI for DCE-higher sensitivity of Pca and specific degree is low, and1H-MRS low sensitivity to Pca, joint1H-MRS quantitative indicators and DCE MRI images show SI-T curve can improve the accuracy of diagnosis of prostate cancer, and can directly show the position and size of lesions and transfer situation, combined with conventional MRI, an accurate staging evaluation of Pca.