MRS与DWI对前列腺中央腺体癌的诊断价值

发布时间：2018-07-10 16:13

本文选题：前列腺癌 + 前列腺增生　；参考：《山东大学》2014年硕士论文

【摘要】：目的：以病理结果为参照,采用Siemens3.0T磁共振仪对前列腺中央腺体疾病患者进行前列腺MRI检查,包括常规序列扫描、磁共振3D1H波谱(MRS)和扩散加权成像(DWI)等,分析采集图像中前列腺中央腺体区疾病包括前列腺癌(PCa)与良性腺体增生(BPH)结节两者在3D1H波谱的代谢变化特点和表观扩散系数--ADC值的差异,探讨高场强磁共振功能成像3D1H MR波谱(MRS)和扩散加权成像(DWI)对前列腺中央腺体癌的检出价值。材料与方法：选取55例前列腺中央腺体疾病患者,在3.0T磁共振仪上行前列腺MRI检查,包括前列腺常规MRI序列、3D’H波谱和扩散加权(DWI)扫描,所有病例均经手术或直肠穿刺活检病理证实,其中15例诊断为前列腺癌(PCa),40例诊断为前列腺增生(BPH)。将所得图像信息数据按前列腺6分区法进行分区测量,15例PCa的中央腺体67个分区为癌,参照穿刺活检或病理取材位置,在磁共振采集图像的中央腺体内相应部位人工设置感兴趣区,测量该区CC/C值和ADC值。综合所得数据,分析前列腺中央腺体区癌(PCa)和良性增生(BPH)结节的3D1H波谱改变特点以及PCa和BPH在DWI中ADC值的差异。波谱采用Siemens工作站上自带Spetroscopy软件测出,ADC值由手工测量得出,所有结果均以x±s形式表示；所得(胆碱±肌酸)/枸橼酸盐(CC/C)值及表观扩散系数(ADC)值采用SPSS11.0软件包进行统计学分析,比较两组间CC/C值和ADC值,采用t检验进行组间比较,P0.05认为有统计学意义。结果：PCa组和BPH组的CC/C值分别为2.93±1.77和0.67±0.39,两组间有统计学差异(P0.05)。PCa组和BPH组的ADC值分别为(0.71±0.32)×10-3mm2·s-1和(1.21±0.26)×10-3mm2·s-1，,癌区与非癌区ADC值结果对比显示PCa的ADC值减低明显,两组间的ADC值的差异亦有统计学意义(P0.05)。但在所测感兴趣区中,PCa组和BPH组两组间的部分ADC值有重叠,具体数值本文未做研究。结论：本研究中采用3.0T高场强磁共振,因增加了MR波谱及DWI扫描等功能成像检查,患者检查时间较常规MRI检查延长,但多数情况下,前列腺各主要代谢物变化特点和ADC值在中央腺体癌中有明显的差异,两者的联合应用对检出前列腺中央腺体癌有重要的价值。
[Abstract]:Objective: to study the MRI of prostate in patients with central prostate gland disease by using Siemens 3.0T magnetic resonance imaging (MRI), including conventional sequence scan, magnetic resonance imaging (Mrs) and diffusion weighted imaging (DWI). The metabolic characteristics and apparent diffusion coefficient (ADC) of prostate cancer (PCA) and benign hyperplasia (BPH) nodules in the central gland region of the prostate were analyzed. To evaluate the value of high field magnetic resonance functional imaging (3D1H) Mr spectroscopy (Mrs) and diffusion weighted imaging (DWI) in detecting central gland carcinoma of the prostate. Materials and methods: a total of 55 patients with central gland disease of prostate were examined with 3. 0T magnetic resonance imaging (MRI), including conventional MRI sequence of prostate 3DX H spectrum and diffusion-weighted (DWI) scan. All the cases were confirmed by operation or rectal biopsy, of which 15 cases were diagnosed as prostate cancer (PCA) and 40 cases were diagnosed as benign prostatic hyperplasia (BPH). The image information data were measured according to the prostate 6 division method. The 67 central glands of 15 patients with PCA were classified as cancer. The location of biopsy or pathological examination was used as reference. The region of interest was manually set up in the central gland of magnetic resonance imaging, and the values of CCR / C and ADC were measured. To analyze the characteristics of 3D1H spectra of prostate central glandular carcinoma (PCA) and benign hyperplasia (BPH) nodules and the difference of ADC values between PCA and BPH on DWI. The ADC values measured by Siemens workstation were obtained by hand, all the results were expressed in the form of x 卤s, and the values of (choline 卤creatine) / citrate (CC-C) and apparent diffusion coefficient (ADC) were analyzed by SPSS 11.0 software package. Compared the CCR C value and ADC value between the two groups, the t test was used to compare the two groups (P0.05) that there was statistical significance. Results the CC-C values of the two groups were 2.93 卤1.77 and 0.67 卤0.39, respectively. There were significant differences between the two groups (P0.05). The ADC values of the PCA group and the BPH group were (0.71 卤0.32) 脳 10-3mm2 s-1 and (1.21 卤0.26) 脳 10-3mm2 s-1, respectively. The difference of ADC value between the two groups was also statistically significant (P0.05). However, some ADC values of PCA group and BPH group are overlapped in the measured region of interest. The specific values are not studied in this paper. Conclusion: in this study, 3.0T high-field magnetic resonance imaging was used. The examination time of patients was longer than that of conventional MRI because of the increase of Mr spectrum and DWI scan, but in most cases, the time of examination was longer than that of conventional MRI. The changes of major metabolites and ADC values of prostate were significantly different in central adenocarcinoma, and the combined use of them was of great value in the detection of central prostate carcinoma.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.25;R445.2

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