Imaging Diagnosis of Prostate Concer using Magnetization Tronsfer Effect

目的：评价磁化转移(MT)磁共振成像在预测前列腺癌恶变和监测前列腺癌激素治疗效果中的可行性。材料和方法：对36例经活检证实的前列腺癌患者(非辅助组21例，新辅助激素组15例)行三维SPGR MR检查，并附加MT脉冲。MT脉冲照射至300 Hz、1200 Hz和2000 Hz三个偏频。使用分析软件(MRVISION)计算所有患者的磁化转移率图像(MTR图像)。测定癌组织、正常外区和良性前列腺增生症(BPH)的MTR。比较非新辅助治疗组与非新辅助激素治疗组的MTR。6例行根治性前列腺切除术(未辅助组3例，新辅助组3例)，MTR图像均为复合…更符合肿瘤定位的病理结果。评价血清前列腺特异性抗原(PSA)水平与肿瘤MTR的相关性。结果：在MT1200和MT2000图像上，正常外区的MTR与癌病变的MTR、正常外区与BPH的MTR之间的差异均有统计学意义。肿瘤病灶的MTR与BPH的MTR无统计学差异。PSA水平与肿瘤的MTR无明显相关性。在3例接受根治性前列腺癌根治术的患者中，MTR图像显示了肿瘤病变，并与病理结果有很好的相关性。然而，在NCO辅助治疗组中，3名接受根治性前列腺切除术的患者的MTR图像的可行性较差。结论：MTR图像可用于评估前列腺癌在前列腺癌外区的定位，当活检后仅用普通MR成像无法解释前列腺癌时，MTR图像可以评估前列腺癌的存在。较少

PURPOSE : To assess the feasibility of magnetization transfer(MT)MR imaging in predicting the rocalization of prostate cancer and in monitoring the effectiveness of hormonal therapy for prostate cancer. MATERIALS AND METHODS : Three-dimensional SPGR MR imaging examinations with additional MT pules were performed in 36 patients(21 of no nco-adjuvant therapy group, 15 of neo-adjuvant hormonal therapy group)with biopsy-proved prostate cancer. MT pulses were irradiated to the three points of off-set frequency, 300Hz, 1200Hz and 2000Hz. Magnetization transfer ratio images(MTR images)were calculated with obtained data in all patients using analytical software (MRVISION). MTRs of cancer lesions, normal outer zone and benign prostatic hyperplasia(BPH)were measured. MTRs of no neo-adjuvant therapy group were compared with those of nco-adjuvant hormonal therapy group. Six patients underwent radical prostatectomy(3 of no nco-adjuvant group, 3 of neo-adjuvant therapy group)and MTR images were comp … More ared with pathological findings of cancer localization. The Correlation between serum prostate-specific antigen(PSA)levels and MTRs of cancer lesions were evaluated. RESULTS : Statistical significance difference was found between MTRs of normal outer zone and those of cancer lesions and between those of normal outer zone and those of BPH on MT1200 and MT2000 images. No statistical difference was found between MTRs of cancer lesions and those of BPH.NO significant correlation was found between PSA levels and MTRs of cancer lesions. In three patients who underwent radical prostatectomy in no neo-adjuvant therapy group, cancer lesions were well demonstrated on MTR images with good correlation to pathological findings. However, feasibility of MTR images was poor in three patients who underwent radical prostatectomy in nco-adjuvant therapy group. CONCLUSION : MTR image was useful to assess cancer localization in prostate outer zone and enables the evaluation for presence of prostate cancer when post biopsy hinder interpretation with ordinary MR imaging alone. Less