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目的探讨扩散加权成像(DWI)、三维氢质子磁共振波谱(3D1H-MRS)对前列腺癌与前列腺炎的鉴别诊断价值。资料与方法搜集经病理或实验室检查证实的前列腺炎患者33例,病理证实前列腺癌患者18例,正常健康自愿者12名,均行前列腺MRI、DWI检查,采用单次激发平面回波成像(echo planar imaging,EPI)序列,b值为0s/mm2和600s/mm2,并行3D1H-MRS检查。结果前列腺炎、前列腺癌和正常前列腺外周带的表观扩散系数(ADC)值分别为(1.60±0.17)×10-3mm2、(0.83±0.13)×10-3mm2、(2.14±0.13)×10-3mm2,组间差异有统计学意义(one-way ANOV,P<0.05),两两组间比较(LSD)各组间均有统计学意义。3D1H-MRS代谢图中(胆碱+肌酸)/枸橼酸盐(Cho+Cre)/Cit分别为0.55±0.21、4.02±1.96、0.43±0.14,组间差异有统计学意义,两两组间比较,前列腺癌组和各组间差异均有统计学意义。结论ADC值和3D1H-MRS对前列腺癌与前列腺炎有重要的诊断和鉴别诊断价值。
Objective To investigate the differential diagnosis of prostate cancer and prostatitis by diffusion-weighted imaging (DWI) and three-dimensional hydrogen proton magnetic resonance spectroscopy (3D1H-MRS). Materials and Methods Collecting 33 cases of prostatitis confirmed by pathology or laboratory tests, 18 cases of prostate cancer confirmed by pathology and 12 normal healthy volunteers were examined by MRI and DWI of prostate, using single excitation plane echo imaging echo planar imaging (EPI) sequence with b values of 0s / mm2 and 600s / mm2 in parallel with 3D1H-MRS. Results The apparent diffusion coefficient (ADC) values of prostatitis, prostate cancer and normal prostate were (1.60 ± 0.17) × 10-3mm2, (0.83 ± 0.13) × 10-3mm2, (2.14 ± 0.13) × 10- 3 mm2. The differences between the two groups were statistically significant (one-way ANOV, P <0.05). There was a significant difference between the two groups in each group (LSD). In the 3D1H-MRS metabolic profile (choline + creatine) / citrate (Cho + Cre) / Cit were 0.55 ± 0.21,4.02 ± 1.96,0.43 ± 0.14, the difference was statistically significant between the two groups Between the two groups, the difference between the prostate cancer group and each group was statistically significant. Conclusion ADC value and 3D1H-MRS have important diagnostic and differential diagnostic value for prostate cancer and prostatitis.