Background and purpose: Cryotherapy of prostate cancer has become one of conventional methods in Europe and America, while in China there is still a lack of evaluation data of prostate cancer after cryotherapy. The aim of the study is to use magnetic resonance spectroscopy (MRS) to quantitative analysis the metabolism dynamic changes in cancerous regions of prostate cancer after cryotherapy. Methods: After digital rectal examination, PSA and MRI, MRS examinations, twenty-two patients with pathologically confirmed prostae cancer underwent cryotherapy, and after therapy all of them subjected to PSA regularity analysis. If PSA>0.5 ng/mL, patieats were received MRI, MRS examination and ultrasound guided biopsy in a week. PSA<0.5 ng/mL in 24 months, they were received MRI, MRS examination and ultrasound guided biopsy in 6, 12 and 24 months after cryotherapy. The cancerous regions were marked by pathologically results, and the choline, creatine and (Cho+Cre)/Cit values of each region were measured. Results: After cryotherapy, there are largely and histologically confirmed necrosis tissue regions, where the choline and citrate can not be observable or decreased gradually. The residual tumor can detect choline and citrate, but the signal noise ratios of them are decreased, the (Cho+Cre)/Cit is not statistically significant different from those before therapy. Conclusion: MRS can be used to evaluate the metabolic dynamic changes of the region of prostate cancer after cyotherapy, which is a valuable clinical method to a traumatic estimate and earlydiagnosis residual prostate cancer after cryotherapy.%背景与目的:氩氦冷冻治疗(cryotherapy)已成为早期前列腺癌(prostate cancer,PCa)首选治疗方法之一,而我国尚缺乏有关前列腺癌冷冻治疗的可评价资料报道.本研究采用磁共振波谱(magnetic resonance spectroscopy,MRS)定量分析前列腺癌冷冻治疗后癌区代谢的动态变化.方法:经直肠指诊、前列腺特异性抗原(prostate-specific antigen,PSA)检测及MRI、MRS检查,最后经病理活检确诊为前列腺癌患者22例,行冷冻治疗,术后定期复查PSA,根据PSA结果,如术后复查PSA＞0.5 ng/mL时,1周内行MRI、MRS检查及超声引导下病理活检,如冷冻术后6、12、24个月内均无PSA升高,可分别于术后6、12、24个月分别行MRI、MRS检查和超声引导下病理穿刺活检.根据病理穿刺确诊为前列腺癌,于对应MRS代谢图上测量兴趣区的胆碱(cho1ine,Cho)、枸橼酸盐(citrate,Cit)及(胆碱+肌酸)/枸橼酸盐[(Cho+Cre)/Cit]即CC/C代谢.结果:冷冻治疗后病理活检可见有大量坏死区,MRS未观察到Cho峰和Cit峰,或Cho峰和Cit峰持续下降.冷冻治疗后病理活检示原位复发,MRS可见有Cho峰和Cit峰,其信噪比较术前降低,而CC/C的比值变化不显著.结论:MRS分析评估PCa冷冻治疗后癌区代谢的动态变化,是无创评价冷冻术后疗效及早期诊断肿瘤复发有价值的临床方法.
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