3.0T磁共振动脉自旋标记(ASL)技术诊断前列腺癌

摘要

Objective:To explore the imaging of the non-cancerous prostate with 3. 0T magnetic resonance arterial spin labeling (ASL) technique and the value of ASL in the diagnosis of prostate cancer. Methods:Thirty-five men suspicious of prostate cancer were enrolled in the study. 17 patients were confirmed by biopsy to be prostate cancer (mean TPSA 207. 77ng/ml,range 0. 76-1733. 24ng/ml;mean age 63. 5 years,range 16-84 years) and in the other 18 subjects no cancer was found (mean TPSA 13. 71ng/ml,range 0. 55~94. 79ng/ml;mean age 70. 6 years,range 51 - 80 years) . The MRI protocol included routine T2 W1, T1 WI and ASL. 10 patient with cancer and 12 patients without cancer also received perfusion weighted imaging (PWI). Results:On ASL,the average perfusion value in peripheral and the central zone in non-cancer group and cancer group was 104.19ml/(100g·min) ,137. 79ml/(100g·min) ,and 152. 80(100g·min),170. 47ml/(100g·min) .respectively. On PWI,the average perfusion value in peripheral and the central zone in 12 non-cancer patients and 10 cancer patients was 176. 55ml/(100g·min),597. 30ml/(100g·min) and 449. 98ml/(100g·min),756. 74ml/(100g-min) ,respectively. There were statistical differences between different zones and different groups where P<0. 05. Conclusion:The patients suspicious of prostate cancer with renal dysfunction or other reasons contraindicated to PWI could benefit from MR ASL examination.%目的:探讨前列腺磁共振动脉自旋标记(ASL)检查的影像学表现及ASL检查在前列腺癌诊断中的价值.方法:35例临床疑似前列腺肿瘤的患者行磁共振检查(包括常规T1WI和T2WI及ASL检查),回顾性分析ASL检查对前列腺肿瘤的诊断价值.以穿刺病理检查结果作为金标准特患者分为两组:前列腺肿瘤组17例,年龄16～84岁,平均63.5岁,总PSA(TPSA)0.76～1733.24 ng/ml,平均207.77 ng/ml;非前列腺肿瘤组18例,年龄51～80岁,平均77.3岁,总PSA 0.55～94.79 ng/ml,平均13.71 ng/ml.其中的12例非前列腺肿瘤和10例前列腺肿瘤患者再行磁共振灌注成像(PWI)检查.结果:ASL检查中18例非前列腺肿瘤患者前列腺外周叶和中央带平均灌注值分别为(104.19±1.65)和(137.79±1.74) ml/(100g·min);17例前列腺肿瘤患者外周叶肿瘤和中央带肿瘤的平均灌注值分别为(152.80±3.38)和(170.47±5.34) ml /(100g ·min).PWI检查中12例非前列腺肿瘤患者外围叶和中央带平均灌注值分别为(176.55±21.44)和(597.30±34.97)ml /(100g·min);10例前列腺肿瘤患者外围叶肿瘤和中央带肿瘤平均灌注值分别为(449.98±21.44)和(756.74±41.14) ml /(100g·min).经统计学分析,前列腺非肿瘤外国叶与中央带、前列腺非肿瘤外围叶与前列腺外围叶肿瘤以及前列腺非肿瘤中央带与前列腺中央带肿瘤ASL检查平均灌注值差异均具有显著性意义(P＜0.05).结论:对于由于肾功能不良或者其它原因不能进行PWI检查而疑似前列腺肿瘤的患者可借助磁共振ASL检查明确诊断.