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目的:探讨3T体线圈三维氢质子磁共振波谱(3D 1H-MRS)在前列腺癌鉴别诊断中的应用价值。方法:对40例临床可疑前列腺癌患者先行3T核磁共振(MRI)和磁共振波谱(MRS)检查,再行直肠B超引导下前列腺穿刺活检获得病理诊断。与病理结果对照,分析良性前列腺增生、前列腺癌、癌前病变MRS代谢特点,评估其对外周带前列腺癌的诊断效能。结果:所有患者均成功完成检查。间质、腺体增生为主内腺、内腺癌灶、外周带癌灶、正常外周带及前列腺上皮内瘤(胆碱+肌酸)/枸橼酸比值分别为:0.75±0.23、0.59±0.14、1.79±0.90、1.18±0.95、0.46±0.18、0.97±0.10。内腺癌灶与增生内腺、外周带癌灶与正常外周带差异有统计学意义(P<0.01)。外周带前列腺癌最佳诊断阈值为0.68,灵敏度88.6%,特异度88.7%。结论:3T体线圈3D 1H-MRS在前列腺癌鉴别诊断中具有较好的敏感性与特异性,对癌前病变的诊断有一定的参考价值。
Objective: To investigate the value of 3D 1H-MRS in the differential diagnosis of prostate cancer. Methods: Forty cases of clinically suspected prostate cancer were examined by 3T MRI and MRS. Prostate biopsy guided by rectum B ultrasound was used for pathological diagnosis. Compared with the pathological results, the characteristics of MRS metabolism in benign prostatic hyperplasia, prostatic cancer and precancerous lesions were analyzed to evaluate its diagnostic efficacy on peripheral prostate cancer. Results: All patients successfully completed the examination. Interstitial and glandular hyperplasia were the main gland, internal gland tumor, peripheral zone tumor, normal peripheral zone and prostatic intraepithelial neoplasia (choline + creatine) / citric acid ratio were 0.75 ± 0.23,0.59 ± 0.14, 1.79 ± 0.90, 1.18 ± 0.95, 0.46 ± 0.18, 0.97 ± 0.10. There were significant differences between the internal adenocarcinoma and the proliferative gland (P <0.01). Peripheral prostate cancer with the best diagnostic threshold of 0.68, 88.6% sensitivity and specificity of 88.7%. Conclusion: 3D 1H-MRS with 3T body coil has good sensitivity and specificity in the differential diagnosis of prostate cancer, and it has certain reference value for the diagnosis of precancerous lesions.