Casciani Emanuele, Polettini Elisabetta, Bertini Luca, Masselli Gabriele, Emiliozzi Paolo, Amini Mostafà, Pansadoro Vito, Gualdi Gian Franco
Department of Radiology, University of Rome “La Sapienza”, Via del Policlinico, 155, 00166, Rome, Italy.
Abdom Imaging. 2007 Nov;32(6):796-802. doi: 10.1007/s00261-007-9181-9. Epub 2007 Feb 10.
To establish the additional value of 3D magnetic resonance spectroscopy (3D-MRS) imaging to endorectal MR imaging in the diagnosis of prostrate cancer in the peripheral zone.
MR imaging and MRS imaging were performed in 79 patients with suspicion of prostate cancer on the basis of digital rectal exploration, transrectal ultrasound and PSA level. All the examinations were performed with 1.5 T MR scan using an endorectal coil (transverse and coronal FSE T2-weighted sequences, axial SE T1-weighted and PRESS 3D CSI). MR examinations have been evaluated by two Radiologists blind of the clinical data in a "per patients" analysis. MR imaging and MRS imaging findings were compared with the result of histological data from radical prostatectomy in 53 patients and biopsy in 17 patients.
Nine patients (11.4%) were excluded because of serious artefacts in the MR spectrum. The reported values of sensitivity, specificity, PPV and NPV for MR imaging alone were respectively 84%, 50%, 76% and 63% (LR+ 1.7; LR- 0.3). Instead the reported values of sensitivity, specificity, PPV and NPV for the combination of MR imaging to MRS imaging were respectively 89%, 79%, 89% and 79% (LR+ 4.28; LR- 0.14). We found an incremental benefit of MRS imaging to MR imaging for tumour diagnosis although these results did not show statistically significant differences.
The MRS imaging improves the accuracy of the endorectal MR imaging in the diagnosis of prostate cancer.
确定三维磁共振波谱（3D-MRS）成像相对于直肠内磁共振成像在诊断外周带前列腺癌方面的附加价值。
对79例基于直肠指诊、经直肠超声和前列腺特异抗原（PSA）水平怀疑患有前列腺癌的患者进行磁共振成像和MRS成像检查。所有检查均使用1.5T磁共振扫描仪及直肠内线圈进行（横轴位和冠状位快速自旋回波T2加权序列、轴位自旋回波T1加权和点分辨表面线圈法3D化学位移成像）。由两名对临床数据不知情的放射科医生在“每位患者”分析中对磁共振检查进行评估。将磁共振成像和MRS成像结果与53例行根治性前列腺切除术患者及17例行活检患者的组织学数据结果进行比较。
9例患者（11.4%）因磁共振波谱中存在严重伪影而被排除。单独磁共振成像的敏感性、特异性、阳性预测值和阴性预测值报告分别为84%、50%、76%和63%（阳性似然比1.7；阴性似然比0.3）。相反，磁共振成像与MRS成像联合的敏感性、特异性、阳性预测值和阴性预测值报告分别为89%、79%、89%和79%（阳性似然比4.28；阴性似然比0.14）。尽管这些结果未显示出统计学显著差异，但我们发现MRS成像相对于磁共振成像在肿瘤诊断方面有增量益处。
MRS成像提高了直肠内磁共振成像在前列腺癌诊断中的准确性。
