中央腺体内前列腺癌3D 1 H-MRSI的初步研究

目的 应用3D氢质子磁共振波谱成像（3D ^1H-MRSI）研究中央腺体（CG）前列腺癌（PC）的代谢特点，并初步探讨3D ^1H-MRSI对CG内PC的鉴别诊断价值。资料与方法 分析18例良性前列腺增生（BPH）和16例PC的3D ^1H-MRSI表现，16例PC中2例源于CG，14例肿块较大同时累及外周带和CG。测量CG内PC及BPH的CG体素（Cho＋Cre）／Cit比值及Cho／Cre比值，并分别对PC与BPH体素的两组代谢物比值进行比较。结果 CG内PC波谱主要表现为Cit峰明显下降甚至消失，Cho峰显著升高，两者波峰可呈现倒置。CG的腺体增生组织主要表现为Cit峰高耸，Cho峰次之，Cre峰最低，基质增生者Cit、Cho峰均降低；CG内PC体素（Cho＋Cre）／Cit比值显著高于BPH的CG（P〈0．001），但两组体素存在部分重叠（29／133，21．8％）。CG内PC体素的Cho／Cre比值明显高于BPH的CG（P〈0．001），但两组之间重叠较多（105／133，78．9％）。结论 CG内PC的诊断存在一定困难，其（Cho＋Cre）／Cit明显高于BPH的CG，但与BPH有部分重叠，综合Cit峰降低、Cho峰升高、Cho／Cre增大有助于CG内PC的检出。

Preliminary Study of Three dimensional Proton MR Spectroscopic Imaging of Prostate Cancer in Central Gland

Objective To assess the metabolic characteristic of prostate cancer (PCa) in central gland (CG) with three dimensional proton MR spectroscopic imaging (3D 1H MRSI), and also to evaluate the value of 3D 1HMRSI in the differential diagnosis of prostate cancer in CG.Materials and Methods 3D ~1H-MRSI findings were reviewed in 18 cases with benign prostatic hyperplasia (BPH) and 16 cases with Pca (2 of CG origin, 14 with large tumor invaded both PZ and CG). (Cho Cre)/Cit and Cho/Cre ratios of PCa and BPH were retrospectively measured, (Cho Cre)/Cit and Cho/Cre of PCa voxels were compared with that of BPH voxels.Results Significantly higher choline levels and lower citrate levels were observed in CG of PCa compared with BPH. In the glandular BPH region, the amount of Cit was high; while in the stromal region, the Cit and Cho level was much lower. (Cho Cre)/Cit ratios of PCa voxels were more higher than that of BPH voxels (P<0.001), PCa voxels had some overlap with BPH voxels (29/133,21.8%). Cho/Cre ratio of PCa voxels were more higher than that of BPH voxels (P<0.001), but there were significant overlap between two groups(105/133,78.9%).Conclusion Evaluation of the CG of PC with imaging is difficult.(Cho Cre)/Cit ratio of CG cancer is significantly higher than that in benign CG tissue, (Cho Cre)/Cit ratio combined with decrease of Cit and elvevation of Cho and Cho/ Cre ratio may be helpful for diagnosis of CG cancer.