Contribution of the MR spectroscopic imaging in the diagnosis of prostate cancer in the peripheral zone
Contribution of the MR spectroscopic imaging in the diagnosis of prostate cancer in the peripheral zone
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DOI：
10.1007/s00261-007-9181-9
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发表时间：
2007-11-01
影响因子：
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通讯作者：
Gualdi, Gian Franco
中科院分区：
文献类型：
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作者：
Casciani, Emanuele;Polettini, Elisabetta;Gualdi, Gian Franco
目的：为探讨3D磁共振波谱（3D-MRS）成像在直肠腔内MR成像基础上对前列腺癌周边区的诊断价值，材料与方法：对79例经直肠指诊、经直肠超声检查及PSA水平检查后疑诊前列腺癌的患者行3D-MRS成像及MR成像。所有检查均采用1.5T直肠内线圈进行，序列包括横断位、冠状位FSE T2加权、轴位SE T1加权和PRESS 3D CSI。在“每例患者”分析中，由两名不了解临床数据的放射科医生对MR检查进行了评价。结果：9例（11.4%）患者因MR频谱伪影严重而被排除，其中17例患者的MRI表现与手术病理结果一致。单独MR成像的敏感性、特异性、PPV和NPV的报告值分别为84%、50%、76%和63%（LR+ 1.7; LR- 0.3）。相反，MR成像与MRS成像组合的敏感性、特异性、PPV和NPV的报告值分别为89%、79%、89%和79%（LR+ 4.28; LR- 0.14）。我们发现一个增量的好处，MRS成像的MR成像的肿瘤diagnosis，虽然这些结果并没有显示统计学显着differences.Conclusions：MRS成像提高了直肠内MR成像在前列腺癌诊断的准确性。
Purpose: To establish the additional value of 3D magnetic resonance spectroscopy (3D-MRS) imaging to endorectal MR imaging in the diagnosis of prostrate cancer in the peripheral zone.Materials and methods: MR imaging and MRS imaging were performed in 79 patients with suspicion of prostate cancer on the basis of digital rectal exploration, transrectal ultrasound and PSA level. All the examinations were performed with 1.5 T MR scan using an endorectal coil (transverse and coronal FSE T2-weighted sequences, axial SE T1-weighted and PRESS 3D CSI). MR examinations have been evaluated by two Radiologists blind of the clinical data in a "per patients" analysis. MR imaging and MRS imaging findings were compared with the result of histological data from radical prostatectomy in 53 patients and biopsy in 17 patients.Results: Nine patients (11.4%) were excluded because of serious artefacts in the MR spectrum. The reported values of sensitivity, specificity, PPV and NPV for MR imaging alone were respectively 84%, 50%, 76% and 63% (LR+ 1.7; LR- 0.3). Instead the reported values of sensitivity, specificity, PPV and NPV for the combination of MR imaging to MRS imaging were respectively 89%, 79%, 89% and 79% (LR+ 4.28; LR- 0.14). We found an incremental benefit of MRS imaging to MR imaging for tumour diagnosis although these results did not show statistically significant differences.Conclusions: The MRS imaging improves the accuracy of the endorectal MR imaging in the diagnosis of prostate cancer.