CAJ | 학술논문

目的：探讨3.0 T磁共振波谱成像（MRS）在前列腺癌诊断中临床应用价值，寻找中央叶与外周带诊断前列腺癌（Cho+Cr）/Cit最佳阈值。方法搜集我院经穿刺活检或手术证实的61例前列腺疾病患者信息，其中前列腺癌患者30例，前列腺增生患者31例，测量MRS每个体素的胆碱（Cho）、肌酸（Cr）、枸橼酸盐（Cit）的相对值，以（Cho+Cr）/Cit的比值衡量前列腺组织物质代谢水平。结果中央叶和外周带的阳性体素与阴性体素（Cho+ Cr）/Cit的比值存在显著性差异，有统计学意义（P<0.001）；中央叶与外中带ROC曲线下面积分别为0.938和0.993。当中央叶（Cho+Cr）/Cit的比值为0.805时，诊断中央叶前列腺癌的灵敏度、特异度为83%和89.8%；当外周带（Cho+Cr）/Cit的比值取0.885时，诊断外周带前列腺癌的敏感度、特异度为98.2%和93.8%。结论3.0 T磁共振MRS在前列腺癌诊断中具有较高的价值，并且MRS诊断外周带前列腺癌价值优于中央叶前列腺癌。
목적：탐토3.0 T자공진파보성상（MRS）재전렬선암진단중림상응용개치，심조중앙협여외주대진단전렬선암（Cho+Cr）/Cit최가역치。방법수집아원경천자활검혹수술증실적61례전렬선질병환자신식，기중전렬선암환자30례，전렬선증생환자31례，측량MRS매개체소적담감（Cho）、기산（Cr）、구연산염（Cit）적상대치，이（Cho+Cr）/Cit적비치형량전렬선조직물질대사수평。결과중앙협화외주대적양성체소여음성체소（Cho+ Cr）/Cit적비치존재현저성차이，유통계학의의（P<0.001）；중앙협여외중대ROC곡선하면적분별위0.938화0.993。당중앙협（Cho+Cr）/Cit적비치위0.805시，진단중앙협전렬선암적령민도、특이도위83%화89.8%；당외주대（Cho+Cr）/Cit적비치취0.885시，진단외주대전렬선암적민감도、특이도위98.2%화93.8%。결론3.0 T자공진MRS재전렬선암진단중구유교고적개치，병차MRS진단외주대전렬선암개치우우중앙협전렬선암。
Objective To assess the optimal threshold for diagnosing prostate cancer in the central and peripheral zones on 3 T magnetic resonance spectroscopic imaging(MRSI).Methods 61 patients with pathologically confirmed prostate cancer(30) and hyperplasia(31)underwent MRSI.The choline(Cho),creatine(Cr),and citrate(Cit)values of each voxel were measured and the(Cho+Cr)/Cit ratios were calculated.Results The(Cho+Cr)/Cit ratios were significantly different between the malignancy and normal tissues in the central and peripheral zones(P<0.001).The areas under the curves were 0.938 in the central zone and 0.993 in the peripheral zone.Using the optimal(Cho+Cr)/Cit threshold of 0.805 in the central zone,the sensitivity and specificity in detecting cancer were 83%and 89.8%,respectively.Using the optimal(Cho+Cr)/Cit threshold of 0.885 in the peripheral zone,the sensitivity and specificity in detecting cancer were 98.2%and 93.8%,respectively.Conclusion 3 T MRSI is valuable in detecting prostate cancer especially in the peripheral zone.