中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2012年
6期
521-525
,共5页
前列腺肿瘤%前列腺增生%磁共振波谱学
前列腺腫瘤%前列腺增生%磁共振波譜學
전렬선종류%전렬선증생%자공진파보학
Prostatic neoplasms%Prostatic hyperplasia%Magnetic resonance spectroscopy
目的 探讨三维氢质子MR波谱成像(3D 1HMRSI)对前列腺移行带癌的检出价值,并评估3D 1HMRSI判断移行带癌侵袭性的可行性.方法 回顾性分析60例常规MR成像疑诊为移行带癌患者的3D' HMRSI资料.参照穿刺活检病理结果,记录移行带癌和前列腺增生体素的(胆碱+肌酸)/枸橼酸盐[( Cho+ Cre)/Cit]比值.采用独立大样本t(’)检验比较移行带癌组和增生组(Cho+Cre)/Cit比值,应用ROC分析评估(Cho+ Cre)/Cit比值对移行带癌的诊断效能.根据Gleason评分将移行带癌分为低危(Gleason评分＜7分)、中危(Gleason评分=7分)和高危(Gleason评分＞7分)3个组,将3个组移行带癌的( Cho+ Cre)/Cit比值进行秩和检验.采用秩相关分析(Cho+ Cre)/Cit比值与Gleason评分的相关性.结果 25例为移行带癌,35例为良性前列腺增生.获取移行带癌体素177个,160个体素3D1HMRSI表现为Cho峰与Cit峰倒置,(Cho+ Cre)/Cit比值增高.前列腺增生体素517个,大多数谱线形态类似正常外周带.移行带癌组与增生组( Cho+ Cre)/Cit比值分别为2.17±1.29和0.77±0.20,差异有统计学意义(t’=14.38,P＜0.01).(Cho+ Cre)/Cit比值用于诊断移行带癌,ROC曲线下面积为0.985(P＜0.01),当(Cho+ Cre)/Cit比值取1.08为诊断临界值时,灵敏度为92.7％,特异度为94.2％,准确度为93.8％.低、中、高危组移行带癌的体素数分别为57、64和56个,( Cho+ Cre)/Cit比值分别为1.43(1.16 ～1.87)、1.66(1.43～2.36)和2.32(1.86 ～3.30),差异有统计学意义(x2=36.282,P＜0.01).(Cho+ Cre)/Cit比值随着Gleason评分的升高而增大,二者呈正相关(r =0.555,P＜0.01).结论 3D 1HMRSI有助于移行带癌的早期检出,(Cho+ Cre)/Cit比值能鉴别移行带癌和增生组织,是有价值的评估移行带癌侵袭性的影像指标.
目的 探討三維氫質子MR波譜成像(3D 1HMRSI)對前列腺移行帶癌的檢齣價值,併評估3D 1HMRSI判斷移行帶癌侵襲性的可行性.方法 迴顧性分析60例常規MR成像疑診為移行帶癌患者的3D' HMRSI資料.參照穿刺活檢病理結果,記錄移行帶癌和前列腺增生體素的(膽堿+肌痠)/枸櫞痠鹽[( Cho+ Cre)/Cit]比值.採用獨立大樣本t(’)檢驗比較移行帶癌組和增生組(Cho+Cre)/Cit比值,應用ROC分析評估(Cho+ Cre)/Cit比值對移行帶癌的診斷效能.根據Gleason評分將移行帶癌分為低危(Gleason評分＜7分)、中危(Gleason評分=7分)和高危(Gleason評分＞7分)3箇組,將3箇組移行帶癌的( Cho+ Cre)/Cit比值進行秩和檢驗.採用秩相關分析(Cho+ Cre)/Cit比值與Gleason評分的相關性.結果 25例為移行帶癌,35例為良性前列腺增生.穫取移行帶癌體素177箇,160箇體素3D1HMRSI錶現為Cho峰與Cit峰倒置,(Cho+ Cre)/Cit比值增高.前列腺增生體素517箇,大多數譜線形態類似正常外週帶.移行帶癌組與增生組( Cho+ Cre)/Cit比值分彆為2.17±1.29和0.77±0.20,差異有統計學意義(t’=14.38,P＜0.01).(Cho+ Cre)/Cit比值用于診斷移行帶癌,ROC麯線下麵積為0.985(P＜0.01),噹(Cho+ Cre)/Cit比值取1.08為診斷臨界值時,靈敏度為92.7％,特異度為94.2％,準確度為93.8％.低、中、高危組移行帶癌的體素數分彆為57、64和56箇,( Cho+ Cre)/Cit比值分彆為1.43(1.16 ～1.87)、1.66(1.43～2.36)和2.32(1.86 ～3.30),差異有統計學意義(x2=36.282,P＜0.01).(Cho+ Cre)/Cit比值隨著Gleason評分的升高而增大,二者呈正相關(r =0.555,P＜0.01).結論 3D 1HMRSI有助于移行帶癌的早期檢齣,(Cho+ Cre)/Cit比值能鑒彆移行帶癌和增生組織,是有價值的評估移行帶癌侵襲性的影像指標.
목적 탐토삼유경질자MR파보성상(3D 1HMRSI)대전렬선이행대암적검출개치,병평고3D 1HMRSI판단이행대암침습성적가행성.방법 회고성분석60례상규MR성상의진위이행대암환자적3D' HMRSI자료.삼조천자활검병리결과,기록이행대암화전렬선증생체소적(담감+기산)/구연산염[( Cho+ Cre)/Cit]비치.채용독립대양본t(’)검험비교이행대암조화증생조(Cho+Cre)/Cit비치,응용ROC분석평고(Cho+ Cre)/Cit비치대이행대암적진단효능.근거Gleason평분장이행대암분위저위(Gleason평분＜7분)、중위(Gleason평분=7분)화고위(Gleason평분＞7분)3개조,장3개조이행대암적( Cho+ Cre)/Cit비치진행질화검험.채용질상관분석(Cho+ Cre)/Cit비치여Gleason평분적상관성.결과 25례위이행대암,35례위량성전렬선증생.획취이행대암체소177개,160개체소3D1HMRSI표현위Cho봉여Cit봉도치,(Cho+ Cre)/Cit비치증고.전렬선증생체소517개,대다수보선형태유사정상외주대.이행대암조여증생조( Cho+ Cre)/Cit비치분별위2.17±1.29화0.77±0.20,차이유통계학의의(t’=14.38,P＜0.01).(Cho+ Cre)/Cit비치용우진단이행대암,ROC곡선하면적위0.985(P＜0.01),당(Cho+ Cre)/Cit비치취1.08위진단림계치시,령민도위92.7％,특이도위94.2％,준학도위93.8％.저、중、고위조이행대암적체소수분별위57、64화56개,( Cho+ Cre)/Cit비치분별위1.43(1.16 ～1.87)、1.66(1.43～2.36)화2.32(1.86 ～3.30),차이유통계학의의(x2=36.282,P＜0.01).(Cho+ Cre)/Cit비치수착Gleason평분적승고이증대,이자정정상관(r =0.555,P＜0.01).결론 3D 1HMRSI유조우이행대암적조기검출,(Cho+ Cre)/Cit비치능감별이행대암화증생조직,시유개치적평고이행대암침습성적영상지표.
Objective To discuss the clinical value of three dimensional proton MR spectroscopic imaging( 3D 1HMRSI) in the detection of transition zone(TZ) prorate cancer and evaluate the feasibility of 3D 1HMRSI for determining the aggressiveness of TZ cancer by analyzing its metabolic characteristics.Methods The 3D 1HMRSI data of sixty patients suspected TZ cancer in conventional MR examinations were retrospectively analyzed.The values of (Cho + Cre)/Cit of TZ cancer and benign prostatic hyperplasia (BPH) voxels were recorded and compared using independent sample t' test,and the area under the ROC curve was used to evaluate the diagnostic accuracy.Based on Gleason scores,TZ cancer voxels were divided into three groups,including low-risk ( Gleason score ＜ 7 ),intermediate-risk ( Gleason score =7 ) and highrisk (Gleason score ＞ 7).The values of (Cho + Cre)/Cit were compared among the three groups using Kruskal-Wallis test.The correlation of the value of (Cho + Cre)/Cit and Gleason score was analyzed using rank correlation analysis.Results Among the 60 patients,histopathology confirmed TZ cancer in 25 patients and BPH in 35 patients.The inversion of Cho and Cit peak value with increased ( Cho + Cre)/Cit was detected in 160 out of 177 TZ cancer voxels.Most spectral curves of the 517 BPH voxels were similar with that of normal peripheral zone on 1HMRSI.The mean values of ( Cho + Cre)/Cit of TZ cancer and BPH voxels were 2.17 ± 1.29 and 0.77 ± 0.20,respectively,with significant difference between them( t' =14.38,P ＜ 0.01).Using (Cho + Cre)/Cit for distinguishing TZ cancer,the area under ROC curve was 0.985 (P ＜ 0.01).With the cut-off point 1.08,the sensitivity,specificity and accuracy of TZ cancer diagnosis was 92.7％,94.2％ and 93.8％,respectively.The number of low-risk,intermediate-risk and high-risk TZ cancer voxels were 57,64 and 56 respectively,and the mean values of ( Cho + Cre)/Cit of the three groups were 1.43 ( 1.16-1.87 ),1.66 ( 1.43-2.36 ) and 2.32 ( 1.86-3.30 ) respectively,with significant difference among them ( x2 =36.282,P ＜ 0.01).The value of ( Cho + Cre )/Cit of TZ cancer increased with the increasing of Gleason score with positive correlation ( r =0.555,P ＜ 0.01).Conclusions TZ caner has a different metabolic profile from BPH.The value of ( Cho + Cre)/Cit on 3D 1HMRSI could provide useful information for early detection and differentiation TZ cancer from BPH.Besides these,( Cho +Cre)/Cit is also a valuable imaging marker to evaluate the aggressiveness of TZ cancer.
