MR功能成像对前列腺癌Gleason评分预估价值的研究

发布时间：2018-06-26 04:01

  本文选题：磁共振波谱成像 + 磁共振弥散成像　； 参考：《安徽医科大学》2014年硕士论文

【摘要】：目的初步探讨磁共振波谱成像（MRS）中的枸橼酸盐/（胆碱+肌酸）［Cit/(Cho+Cr)，C/CC］与弥散加权成像（DWI）中的ADC值对前列腺癌Gleason评分的预估价值，为前列腺癌的早期诊断、病理分级、手术方式及术后复发的监测提供重要的影像学依据，进而提高患者的生存率及生活质量。 方法①回顾性的分析40例经超声引导下穿刺活检确诊为前列腺癌患者的磁共振波谱，分别测得每例患者兴趣区的C/CC值，在超声引导下穿刺兴趣点，获得相应的Gleason评分，将C/CC值与穿刺病理的Gleason评分结果进行对照，通过绘制散点图及Spearman相关分析探讨二者的相关性，再根据C/CC值，对Gleason评分7组与Gleason评分≥7组进行独立样本t检验，p0.05视为有显著统计学意义。将每一个C/CC值与对应的Gleason评分进行线性回归分析。②回顾性分析40例经超声引导下穿刺活检确诊为前列腺癌患者的DWI图像，分别测得每例患者兴趣区的ADC值，获得相应的Gleason评分，将ADC值与穿刺病理的Gleason评分结果进行对照，通过Spearman相关分析探讨两者的相关性。 结果①40例患者共计测得200个兴趣区域的C/CC值，每例患者分别计算其平均C/CC值，经Spearman相关分析，，C/CC值与对应区的Gleason评分呈负相关（r=-0.698，p=0.01）。Gleason评分7的高分化癌组的C/CC值平均为0.561±0.108，Gleason评分≥7的中低分化癌组的C/CC值平均为0.424±0.139，两组间差异有统计学意义(t=3.22，p=0.02)。经回归分析，每个Gleason评分与C/CC值存在一定的对应关系，方差分析结果（F=54.304，P=0.000）表明回归方程具有统计学意义，决定系数R2=0.459。②40例患者共计测得160个兴趣区域的ADC值，每例患者分别计算其平均ADC值，经Spearman相关分析，ADC值与对应区的Gleason评分呈负相关（r=-0.578，p=0.01）。Gleason评分7的高分化癌组的ADC值平均为（0.821±0.128）×10-3mm2/s， Gleason评分≥7的中低分化癌组的ADC值平均为（0.644±0.149）×10-3mm2/s，两组间差异有统计学意义(t=3.12，p=0.01)。 结论磁共振功能成像中的C/CC值和ADC值均与Gleason评分呈负相关，MRS及DWI对前列腺癌的评分有指导意义，可在无创的方式下用于前列腺癌Gleason评分的预估。
[Abstract]:Objective to evaluate the predictive value of citrate / (choline creatine) (citrate / (Cho Cr) C / CC) and diffusion weighted imaging (DWI) in Gleason score of prostate cancer in magnetic resonance spectroscopy (Mrs), which is the early diagnosis and pathological grade of prostate cancer. The method of operation and the monitoring of postoperative recurrence provide important imaging evidence to improve the survival rate and quality of life of patients. Methods 1 the magnetic resonance spectroscopy of 40 patients with prostate cancer diagnosed by ultrasound guided biopsy were retrospectively analyzed. The values of C / CC in each patient's area of interest were measured, and the corresponding Gleason score was obtained under the guidance of ultrasound. The C- / CC value was compared with the Gleason score of puncture pathology, and the correlation between them was discussed by drawing scatter plot and Spearman correlation analysis, and then according to the C- / CC value, Gleason score 7 group and Gleason score 鈮

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