王霄英,周良平,丁建平,李飞宇,山刚志,肖江喜,蒋学祥.MRS对中国人前列腺癌鉴别诊断标准的初步研究[J].中国医学影像技术,2004,20(8):1150~1153
MRS对中国人前列腺癌鉴别诊断标准的初步研究
Quantitative criteria of MR spectroscopy in the differential diagnosis of prostate cancer in China: preliminary study
投稿时间:2004-06-16  
DOI:
中文关键词:  磁共振波谱  前列腺癌  诊断
英文关键词:Magnetic resonance spectroscopy  Prostate cancer  Diagnosis
基金项目:
作者单位E-mail
王霄英 北京大学第一医院医学影像科, 北京 100034 bjwxycn@tom.com 
周良平 复旦大学附属肿瘤医院放射科  
丁建平 河北省第三医院放射科  
李飞宇 北京大学第一医院医学影像科, 北京 100034  
山刚志 北京大学第一医院医学泌尿外科, 北京 100034  
肖江喜 北京大学第一医院医学影像科, 北京 100034  
蒋学祥 北京大学第一医院医学影像科, 北京 100034  
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中文摘要:
      目的 评价磁共振波谱分析(MRS)对前列腺癌(PCa)的鉴别诊断价值,初步确定中国人前列腺癌的MRS诊断标准。方法 经手术病理或穿刺活检证实的PCa 21例、良性前列腺增生23例和正常老年志愿者17例以六分区的方法进行MRS定量分析。在MRS代谢图上标记出手术病理或穿刺活检取材位置归入相应的分区,测量其(胆碱+肌酸)/枸椽酸盐[(choline+creatine)/citrate, CC/C]的比值。计算MRS对癌区外周带和非癌区外周带(包括BPH患者的和PCa患者的)定性诊断的准确性。结果 正常前列腺外周带、PCa患者癌区外周带及非癌区外周带的CC/C值分别为:0.42±0.19、2.13±0.82和0.60±0.20。以正常人CC/C值的Ax-G+3SD为癌的诊断标准,将CC/C>0.99者诊断为PCa区。本标准和国外文献标准(CC/C>0.86)鉴别PCa区与非PCa区的敏感性分别为96.0%和97.3%(χ2=0.207, P=0.649),特异性分别为94.7%和86.3%(χ2=4.563, P=0.005),准确性分别为95.1%和89.4%(χ2=5.950, P=0.015)。结论 以CC/C>0.99为标准鉴别中国人前列腺外周带的PCa和非PCa组织有较高的特异性和准确性。
英文摘要:
      Objective To evaluate the value of MR spectroscopy in the differential diagnosis of prostate cancer and to incipiently determine the diagnostic criteria of prostate cancer in China using MRS. Methods Twenty-one cases of prostate cancer and 23 cases of BPH all proved by pathology of operation or systemic biopsy and 17 cases of normal volunteer were quantitatively assessed on a per sextant (region) by MRS. The locations of prostate cancer were marked by the surgeon and enrolled in a region. The corresponding ratios of (Cho+Cre)/Cit were calculated on the basis of the MRS metabolic map. The diagnostic accuracy of MRS for prostate cancer was calculated. Results The average ratios of (Cho+Cre)/Cit in the peripheral zone of normal prostate, cancerous and noncancerous regions were 0.42±0.19, 2.13±0.82 and 0.60±0.20, respectively. Taking the high limit of normal variance (Ax-G+3SD) as diagnostic threshold, that is, the areas with (Cho+Cre)/Cit>0.99 be considered as prostate cancer, the diagnostic sensitivity, specificity and accuracy was 96.0%, 94.7% and 95.1%, respectively. Taking the previously reported criteria as diagnostic threshold, that is, the areas with (Cho+Cre)/Cit>0.86 be considered as prostate cancer, the diagnostic sensitivity, specificity and accuracy was 97.3%, 86.3% and 89.4%, respectively. There was no statistically difference between the sensitivity (χ2=0.207, P=0.649), but there were statistically differences between the specificity (χ2=4.563, P=0.005) and accuracy (χ2=5.950, P=0.015). Conclusion The ratio of (Cho+Cre)/Cit >0.99 is a preferable threshold to differentiate prostate cancer and noncancerous tissue.
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