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Three Dimensional Magnetic Resonance Spectroscopy in Prostate Gland of Chinese Males: Quantification Analysis of Normal Young Adult, Benign Prostate Hyperplasia and Prostate Adenocarcinoma Patients<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
王霄英* 周良平*
丁建平* 蒋学祥*
山刚志# 王 刚#
＊北京大学第一医院 医学影像科
#北京大学第一医院 泌尿外科
Xiaoying Wang, Liangping Zhou, Jianping Ding, Xuexiang Jiang, Gangzhi Shan, Gang Wang
Radiology Department of Peking University First Hospital
ABSTRACT
Purpose: To quantitatively evaluate the metabolic level of normal prostate gland in Chinese male adults, and that of benign prostate hyperplasia(BPH) and prostate adenocarcinoma(PCa) patients using three dimensional magnetic resonance spectroscopy(3D MRS).
Material and Method: 1) 10 cases with no clinical indication of prostate disease were examined using MRI and MRS. The right and left side of the peripheral and central zone were divided into bottom, middle and tip regions. So 12 samples were obtained from each case. The metabolic ratio of (Choline+Creatine)/Citrate, [(Cho+Cre)/Cit] was measured. 2) 33 patients with pathologically proved BPH and 31 patients with PCa proved by ultrasound guided systemic biopsy were enrolled in this study. All the puncture locations were marked and the corresponding (Cho+Cre)/Cit ratios were calculated on the basis of the MRS metabolic map.
Result: 1) In the normal group(n=10), the mean ratios of (Cho+Cre)/Cit in the central zone of different individuals were not significantly different(P>0.05), the mean value was 0.75¡À0.33 (mean¡Àstandard deviation). The mean ratios of (Cho+Cre)/Cit in the peripheral zone of different individuals were not significantly different(P>0.05), the mean value was 0.51¡À0.20 (mean¡Àstandard deviation). Statistically significant variation in metabolic levels with peripheral zone and central zone was detected (P<0.05). 2) In the BPH group(n=33), 248 samples were obtained. The average (Cho+Cre)/Cit ratio in these positions was 0.60¡À0.37 (mean¡Àstandard deviation). 3) In the PCa group(n=31), 304 samples were obtained and 175 were diagnosed as cancer. The average (Cho+Cre)/Cit ratio in these 175 positions was 2.23¡À1.00 (mean¡Àstandard deviation). 4) There is no significant statistical difference of the metabolic level in the peripheral zone between the normal adult and the BPH patients(P>0.05), whereas there is significant statistical difference between the PCa and the other two groups(P<0.01).
Conclusion: The metabolic levels of prostate gland could be evaluated quantitatively. The metabolic level of the PCa patients is different from that of the normal and BPH patients.
Key Words: Magnetic resonance spectroscopy; Prostate, Neoplasm; Benign prostate hyperplasia
早期诊断、准确分期中有重要价值，尤其是当一些因素(如合并有穿刺后出血、内分泌和放射治疗后改变等)使常规MRI诊断的准确性降低时[2, 3]，MRS提供的代谢信息能提高对肿瘤残存和复发的诊断准确性[4]。国内初步研究的结果认为前列腺的MRS检查对中国人是可行的[5]。本文用三维磁共振波谱分析(Three Dimensional Magnetic Resonance Spectroscopy, 3D MRS)方法定量测量中国正常成年男性前列腺中央带和外周带、良性前列腺增生(Benign Prostate Hyperplasia, BPH)及前列腺癌患者病灶区的代谢水平。 | 
