Localizing prostate cancer in the presence of postbiopsy changes on MR images: Role of proton MR spectroscopic imaging
Localizing prostate cancer in the presence of postbiopsy changes on MR images: Role of proton MR spectroscopic imaging
复制标题
DOI：
10.1148/radiology.206.3.9494502
复制
发表时间：
1998-03-01
期刊：
影响因子：
19.7
通讯作者：
Vigneron, DB
中科院分区：
文献类型：
--
作者：
Kaji, Y;Kurhanewicz, J;Vigneron, DB
目的：评估磁共振 (MR) 波谱成像与 MR 成像是否可以改善活检后出血病例中前列腺癌的定位。材料和方法：对 175 例前列腺癌患者的记录进行回顾性分析。 42 名患者（135 个出血部位）具有空间相关的活检数据。患者在经直肠超声 (US) 引导活检后 180 天内接受了相控阵线圈-直肠内线圈 MR 成像和三维 MR 光谱成像。记录T1加权图像上的高信号强度出血和T2加权图像上相应的高或低信号强度区域以及代谢比（胆碱+肌酸）/柠檬酸盐。癌症被确定为 T2 加权 MR 成像中的低信号强度区域，或者 MR 光谱成像中代谢物比率高于正常值 3 个标准差以上。比较 MR 成像、光谱和活检结果。结果：49 名患者出现活检后出血。在 T2 加权图像上，较高百分比 (P < .01) 的出血部位表现出低信号强度（80% [135 个部位中的 108 个部位]），这与癌症中观察到的信号强度相似。在 MR 成像中添加 MR 光谱成像可显着提高 (P < .01) 肿瘤检测的准确性（52% 至 75%）和特异性（26% 至 66%）。结论：当活检后变化妨碍单独使用 MR 成像进行解释时，在 MR 成像中添加 MR 光谱成像可显着提高确定前列腺癌存在和空间范围的能力。
PURPOSE: To assess whether magnetic resonance (MR) spectroscopic imaging with MR imaging can improve prostate cancer localization in postbiopsy hemorrhage cases.MATERIALS AND METHODS: Records of 175 patients with prostate cancer were retrospectively reviewed; 42 patients (135 hemorrhagic sites) had spatially correlated biopsy data. Patients underwent both phased-array coil-endorectal coil MR imaging and three-dimensional MR spectroscopic imaging within 180 days after transrectal ultrasound (US)-guided biopsy. High-signal-intensity hemorrhage on T1-weighted images and corresponding high- or low-signal-intensity areas on T2-weighted images and the metabolic ratio (choline + creatine)/citrate were recorded. Cancer was identified as a low-signal-intensity area at T2-weighted MR imaging or a metabolite ratio greater than 3 standard deviations above normal at MR spectroscopic imaging. MR imaging, spectroscopic, and biopsy findings were compared.RESULTS: Forty-nine patients had postbiopsy hemorrhage. On T2-weighted images, a higher (P < .01) percentage of hemorrhagic sites demonstrated low signal intensity (80% [108 of 135 sites]), which is similar to the signal intensity seen with cancer. The addition of MR spectroscopic imaging to MR imaging resulted in a significant increase (P < .01) in the accuracy (52% to 75%) and specificity (26% to 66%) of tumor detection.CONCLUSION: The addition of MR spectroscopic imaging to MR imaging significantly improves the ability to determine the presence of prostate cancer and spatial extent when postbiopsy changes hinder interpretation with MR imaging alone.