目的:探讨3.0T磁共振波谱成像(MRSI)结合扩散加权成像(DWI)在前列腺中央腺体癌中的诊断价值。方法:回顾性分析术前MRSI与DWI结合诊断为前列腺中央腺体癌的患者共18例,术后确诊为前列腺癌16例、前列增生1例、前列腺增生伴前列腺中度到重度炎症1例。其中3例已经确诊中央腺体癌为激素治疗后行MRI检查。比较患者癌区与对侧非癌区两组间的(胆碱+肌酸)/枸橼酸盐(CC/C)值。结果:无任何治疗的13例中央腺体癌区158个体素的CC/C值均值为2.684±1.7,非癌区196个体素的CC/C均值为0.49±0.08。(T值为2.778,P值均=0.017〈0.05),中央腺体癌区与对侧非癌区之间的CC/C值差异有统计学意义。3例激素去势治疗后癌区的CC/C均值为1.18±0.95,非癌区22个体素CC/C均值为0.46±0.255。(T值为1.196,P值均=0.354〉0.05)。激素治疗后中央腺体癌区与对侧非癌区之间的CC/C值差异无统计学意义。结论:MRSI结合DWI显著提高前列腺中央腺体癌的诊断。
Objective: To discuss the value of 3.0T MR spectroscopic imaging(MRSI) combined with diffusion-weighted imaging(DWI) in detecting the prostatic central gland cancer. Methods: The clinical and MR imaging data of 18 patients were analyzed retrospectively, here were 16 cases suffered from prostatic central gland cancer after surgery, 1 case suffered from prostate hyperplasia,and 1 case suffered from prostate hyperplasia and inflammation from mid to high level. 3 cases among the 16 cancer had been treated with hormone before MRI. CC/C values of patients' cancerous zone and non-cancerous zone were compared. Results: In the prostatic central gland cancer zone, the 158 voxels' CC/C average value of the 13 cases without any treatment is 2.684±1.7, however, the CC/C average of 196 voxels is only 0.49±0. 08 in the non-cancerous zone, which has statistically significant difference between the CC/C value of the prostatic central gland cancer and non-cancer zone without any treatment(T values were 2.778, P values =0.017〈 0.05). As for the 3 cases, which took the hormone therapy, heir 44 voxels' CC/C average value of cancerous zone is 1.18 ±0. 95, and the 22voxels' CC/C average value of non-cancerous zone is 0.46±0. 255, which has no statistically significant difference between the CC/C value of the prostatic central gland cancer and non-cancer zone after treated of hormone(T values were1.196, P values=0.354〈 0.05).Conclusion: MRSI combined with DWI significantly improve the central gland prostate cancer diagnosis.