目的探讨前列腺癌及良性前列腺增生的^1H-MRSI代谢比率与血管生成的内在关系。方法研究对象为71例行^1H-MRSI检查的前列腺疾病患者,其中前列腺癌(prostate cancer,PCa)为38例,良性前列腺增生(benign prostatic hyperplasia,BPH)为33例。磁共振检查使用Siemens Sonata1.5T高场强超导MR成像仪和腹部相控阵线圈,^1H-MRSI数据采集使用CSI-3D-Prostate序列,数据传输到西门子Leonardo工作站和Spectroscopy软件进行波谱数据处理。前列腺癌和BPH的MVD及VEGF表达水平使用免疫组化染色进行检测。前列腺癌(Cho+Cr)/Cit比率与MVD及VEGF表达水平相关性分析用Pearson相关分析。结果PCa、BPH及正常外周带的(Cho+Cr)/Cit比率分别为3.98±0.12、0.56±0.22和0.39±0.08,三者代谢比率存在显著差异(P〈0.05)。前列腺癌MVD、VEGF分别为28.1/视野和69.2%;BPH的MVD、VEGF分别为17.6/视野和34.6%。前列腺癌血管生成水平高于BPH(P〈0.05)。前列腺癌(Cho+Cr)/Cit比率与MVD、Gleason分级存在正相关性(r=0.348、0.431,P〈0.05)。结论前列腺癌的代谢水平与血管生成密切相关,^1H-MRSI能对前列腺癌生物学特性进行初步评估。
Objective To study the relationship between MRI/MRSI and angiogenesis in prostate cancer (PCa) and benign prostatic hyperplasia(BPH). Methods 38 patients with PCa and 33 cases with BPH histologically proven were studied. MR examinations were performed in the supine position using a 1.5T superconductive magnet scanner (Siemens Sonata) with a pelvic phased array multioil. Three dimensional proton MR spectroscopic imaging (3D-^1H-MRSI) was acquired using CSI-3D-Prostate sequence. All of the data were transferred to Siemens Leonardo Workstation. The choline plus creatine-to-citrate ratios [(Cho+ Cr)/Cit] of PCa , BPH and peripheral zone ( PZ ) of prostate were calculated by spectroscopy software. All specimens were stained using immunohistochemical technique. The microvessel density (MVD) and vascular endothelial growth factor (VEGF) of PCa were detected. The relationship between MRI/MRSI and MVD, VEGF of PCa were analyzed by SPSS 11.5. Results The (Cho+Cr)/ Cit of PCa, BPH and PZ were 3.98±0.12, 0. 56±0. 22 and 0.39±0.08 respectively. The (Cho+Cr)/Cit ratio of Pca was higher than that of BPH and PZ (P〈0.05). The average MVD and VEGF of prostatic cancer were 28.1/field and 69.2 %, while the average MVD and VEGF of BPH were 17.6/field and 34.6%. The mean MVD and VEGF of prostatic cancer were higher than that of BPH (P〈0.05). (Cho+Cr)/Cit ratios of prostatic cancer correlated positively with MVD and Gleason grade (r= 0. 348, 0. 431, P〈0.05). Conclusion The angiogenesis of prostatic disease is related closely with the metabolic features. MRI/MRSI can help to understand variables of angiogenesis of PCa non-invasively.