| 李飒英,陈 敏,周 诚,王文超,张 晨.活检后出血对前列腺癌1H磁共振波谱数据的影响[J].中国医学影像技术,2003,19(7): |
| 活检后出血对前列腺癌1H磁共振波谱数据的影响 |
| Prostate Cancer:Effect of Extensive Post-Biopsy Hemorrhage on Interpretation of 1H MRSI Data |
| 投稿时间：2003-03-19 |
| DOI： |
| 中文关键词: 磁共振波谱成像 前列腺癌 活检后出血 |
| 英文关键词:Magnetic resonance spectroscopic imaging Prostate cancer Post-biopsy hemorrhage |
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| 中文摘要: |
| 目的 确定前列腺活检后出血导致的代谢改变对1H磁共振波谱成像(1H MRSI)探查前列腺癌的影响,并总结在出血存在下分析和解释波谱的指导方法。方法 60个活检证实前列腺癌的病人在活检后平均11周和48周了进行了MRI/MRSI检查。出血的存在是以MRI T1 加权像(T1WI)高信号作为标准。(胆碱＋肌酐)/枸橼酸盐比值高于正常值2个标准差被定义为代谢异常。前列腺周围带出血和无出血体素内CC/C值的比较是在同一病人内进行。结果 活检后出血的病人在出血消退后萎缩体素的数量(P<0.05)和异常体素的数量明显减少(P<0.05)。在87个出血的体素内,有66%(42/64)的健康体素可探测到代谢物质波谱,依据CC/C比值,其中62%(26/42)的健康体素被误诊为癌。同时,有34%(22/64)的健康体素表现为代谢萎缩。在23个癌症体素中,有43%(10/23)的癌症体素被低估为萎缩。结论 对于有出血存在的体素,在诊断为癌症之前,应用胆硷水平比肌酐高的标准评价,使癌症的误诊率能够明显降低(从38%到2.3%)。 |
| 英文摘要: |
| Objective To determine the impact of these hemorrhage-induced metabolic changes on cancer detection by 1H magnetic resonance spectroscopic imaging (3D-MRSI),and to develop guidelines for the interpretation of proton spectra in the presence of hemorrhage.Methods Sixty patients with biopsy-proven prostate cancer were studied at a mean of 11 and 48 weeks after biopsy.The presence of hemorrhage was based on high T1-weighted signal intensity on MRI,and spectra were considered to be metabolically abnormal when they had a CC/C ratio greater than 2 std.above normal values.CC/C ratios in peripheral zone of the prostate,with and without hemorrhage,were compared in the same patient.Results Patients with biopsy artifacts demonstrated a significant reduction in the number of atrophied (P<0.05) and abnormal spectroscopic voxels (P<0.05) after the biopsy artifacts abated.In 87 voxels with biopsy hemorrhage,65% (42/64) of the healthy voxels had detectable metabolites,62% (26/42) were accurately identified as healthy,while 38%(16/42) were misinterpreted as being cancer based on the CC/C ratio.34% (22/64) of the healthy voxels demonstrated metabolic atrophy at the first time point.In 23 cancer voxels,43%(10/23) were underestimated as atrophy.Conclusion The overestimation of cancer could be dramatically reduced (from 38% to 2.3%) by requiring choline in voxels with biopsy artifacts to be elevated (Cho/Cr>1.5) before identifying a voxel as malignant. |
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