前列腺癌和前列腺增生的MRS研究

目的探讨磁共振波谱分析(MRS)在前列腺病变诊断中的价值。方法对27例前列腺病变前列腺癌(PCa)10例,前列腺增生(BPH)17例]的MRI和MRS表现进行研究。MRI平扫观察前列腺病变的位置、形态、大小及信号特点;MRS则观察枸橼酸盐(Cit)和胆碱复合物(Cho)、肌酸(Cre)的波峰及化学位移,并测定(Cho Cre)Cit值。结果10例PCa在T2WI图像上表现为外周带的信号减低,其中6例为单侧局灶性,4例为双侧弥漫性;17例BPH在T2WI上均显示前列腺移行带和中央带的增大,其中12例表现为局灶性结节状高、低信号,5例表现为弥漫性体积增大,呈均匀低、等信号。MRS显示PCa的Cit峰明显下降,Cho峰升高,(Cho Cre)Cit值降低,而BPH病灶各代谢物波峰变化不明显,两者间(Cho Cre)Cit值有显著性差异(P<0.05)。结论常规MRI平扫与MRS的联合应用有利于提高PCa和BPH的诊断与鉴别诊断率。

Study on prostate cancer and benign prostatic hyperplasia with MRS

Objective To assess magnetic resonance spectroscopy (MRS) value in diagnosis of prostate diseases. Methods Magnetic resonance imaging (MRI) and MRS appearances were researched in 27 patients with prostate diseases, 17 cases were benign prostatic hyperplasia(BPH) and 10 cases were prostate cancer (PCa). MRI observation was focused on the size and configuration of the gland, the location of the lesion, the signal intensity of the tumor. MRS observation included the peak and the chemical shift of citrate(Cit), choline(Cho) and creatine(Cre) spectra, and the ratio of (Cho Cre)/Cit. Results In 10 cases of PCa, low T_2WI signal intensity area in the peripheral zone was observed, 6 cases with localized mono-side and 4 cases with bi-sides diffuse. In 17 cases of BPH, enlargement of the transitional and central zone of the grand was found on T_2WI images, 12 of which the hyperplasia presented as focal round high or low-signal intensity nodular lesions and in the other 5 cases, the lesions were characterized by diffuse enlargement and well-distributed low or iso-signal intensity. On MRS, citrate peak was obviously declined and choline peak was ascended with the (Cho Cre)/Cit ratio being significantly dropped in PCa (P<0.05, compared with that in BPH). Conclusion It is very helpful for the differentiation of BPH with PCa by using combined MRS and MRI.