扩散加权成像和3D~1H-MRS对前列腺癌与前列腺炎的鉴别诊断价值

目的 探讨扩散加权成像(DWI)、三维氢质子磁共振波谱(3D~1H-MRS)对前列腺癌与前列腺炎的鉴别诊断价值.资料与方法 搜集经病理或实验室检查证实的前列腺炎患者33例,病理证实前列腺癌患者18例,正常健康自愿者12名,均行前列腺MRI、DWI检查,采用单次激发平面回波成像(echo planar imaging,EPI)序列,b值为0 s/mm~2和600 s/mm~2,并行3D~1H-MRS检查.结果 前列腺炎、前列腺癌和正常前列腺外周带的表观扩散系数(ADC)值分别为(1.60±0.17)×10~(-3)mm~2、(0.83±0.13)×10~(-3)mm~2、(2.14±0.13)×10~(-3)mm~2,组间差异有统计学意义(one-way ANOV,P<0.05),两两组间比较(LSD)各组间均有统计学意义.3D~1H-MRS代谢图中(胆碱+肌酸)/枸橼酸盐(Cho+Cre)/Cit分别为0.55±0.21、4.02±1.96、0.43±0.14,组间差异有统计学意义,两两组间比较,前列腺癌组和各组间差异均有统计学意义.结论 ADC值和3D~1H-MRS对前列腺癌与前列腺炎有重要的诊断和鉴别诊断价值.

The Value of DWI and 3D ~1H-MRS for the Differential Diagnosis of Prostate Cancer and Prostatitis

Objective To research the value of DWI,3D ~1H-MRS for the differential diagnosis of prostate cancer and prostatitis. Materials and Methods 33 cases of prostatitis (mean age 31 years , from 19 to 45, proved by pathology or Laboratory test), 18 cases of prostate cancers (mean age 67 years, from 54 to 83, proved by pathology) and 12 cases of normal volunteers (mean age 28 years, from 19 to 40) were included in the research. DWI(b-values =0 s/mm~2 and 600 s/ mm~2) and 3D ~1H-MRS images were obtained for all cases on Philips 1.5T system. Results The mean ADC values of prostatitis, prostate cancer and normal volunteer were(1.60±0.17)×10~(-3) mm~2 , (0.83±0.13)×10~(-3) mm~2 and(2.14± 0.13)×10~(-3) mm~2 respectivily. Statistical significant difference(one-way ANOV,P < 0.05)was found. Furthermore,statistical significant difference also existed between every two groups (LSD). The mean (Cho + Cre)/Cit values of the prostati-tis, prostate cancer and normal peripheral zone were 0.55±0.21,4.02±1.96,0.43±0.14, respectivily. Statistical significant difference(one-way ANOV,P <0.05)was found, There are statistical significant difference in every groups compared with Prostate cancer group. Conclusion ADC value and 3D ~1H-MRS have important value on the diagnosis and differential diagnosis of prostatitis and prostate cancer.