前列腺磁共振成像：利用药代动力学容积和血流参数进行组织特征分析及其与组织学参数的相关性

Prostate MR imaging: tissue characterization with pharmacokinetic volume and blood flow parameters and correlation with histologic parameters.

作者信息

Franiel Tobias, Lüdemann Lutz, Rudolph Birgit, Rehbein Hagen, Stephan Carsten, Taupitz Matthias, Beyersdorff Dirk

机构信息

Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.

出版信息

Radiology. 2009 Jul;252(1):101-8. doi: 10.1148/radiol.2521081400.

DOI:10.1148/radiol.2521081400

PMID:19561252

Abstract

PURPOSE

To prospectively determine whether pharmacokinetic magnetic resonance (MR) imaging parameters correlate with histologic mean vessel density (MVD), mean vessel area (MVA), and mean interstitial area (MIA) and whether these parameters enable differentiation of prostate cancer, chronic prostatitis, and normal prostate tissue.

MATERIALS AND METHODS

This study was approved by the institutional review board, and informed consent was obtained from all patients. Thirty-five patients with biopsy-proved prostate cancer were examined with a dynamic contrast material-enhanced inversion-prepared dual-contrast gradient-echo sequence (temporal resolution, 1.65 seconds) at 1.5 T to calculate blood volume, interstitial volume, and blood flow. These parameters were correlated with MVD, MVA, and MIA in 95 areas (prostate cancer, n = 36; chronic prostatitis, n = 27; normal prostate tissue, n = 32). For each MR area, five 1-mm(2) squares (original magnification, x100) of the matching histologic area were analyzed. The Wilcoxon signed-rank test was used for statistical analysis.

RESULTS

Blood volume correlated poorly with MVD (Spearman correlation coefficient, 0.252; P = .014) but did not correlate at all with MVA (P = .759). Interstitial volume did not correlate with MIA (P = .507). Blood volume differed between patients with prostate cancer and those with a normal prostate (1.49% vs 0.84%, respectively; P < .001). Interstitial volume differed between patients with chronic prostatitis and those with a normal prostate (39.00% vs 22.59%, respectively; P = .022). Blood flow differed between patients with prostate cancer and those with a normal prostate (0.97 mL/[cm(3) x min(-1)] vs 0.34 mL/[cm(3) x min(-1)], respectively; P < .001), between patients with prostate cancer and those with chronic prostatitis (0.97 mL/[cm(3) x min(-1)] vs 0.60 mL/[cm(3) x min(-1)], respectively; P = .026), and between patients with chronic prostatitis and those with a normal prostate (0.60 mL/[cm(3) x min(-1)] vs 0.34 mL/[cm(3) x min(-1)], respectively; P = .023).

CONCLUSION

Blood volume and interstitial volume did not reliably correlate with the histologic parameters. Only blood flow enabled differentiation of prostate cancer, chronic prostatitis, and normal prostate tissue.

摘要

目的

前瞻性地确定药代动力学磁共振（MR）成像参数是否与组织学平均血管密度（MVD）、平均血管面积（MVA）和平均间质面积（MIA）相关，以及这些参数是否能够区分前列腺癌、慢性前列腺炎和正常前列腺组织。

材料与方法

本研究经机构审查委员会批准，并获得所有患者的知情同意。35例经活检证实为前列腺癌的患者接受了1.5T的动态对比剂增强反转预饱和双对比梯度回波序列（时间分辨率为1.65秒）检查，以计算血容量、间质容量和血流。这些参数与95个区域的MVD、MVA和MIA相关（前列腺癌，n = 36；慢性前列腺炎，n = 27；正常前列腺组织，n = 32）。对于每个MR区域，分析了匹配组织学区域的五个1平方毫米（原始放大倍数，x100）的方块。采用Wilcoxon符号秩检验进行统计分析。

结果

血容量与MVD的相关性较差（Spearman相关系数，0.252；P = 0.014），但与MVA完全不相关（P = 0.759）。间质容量与MIA不相关（P = 0.507）。前列腺癌患者与正常前列腺患者的血容量不同（分别为1.49%和0.84%；P < 0.001）。慢性前列腺炎患者与正常前列腺患者的间质容量不同（分别为39.00%和22.59%；P = 0.022）。前列腺癌患者与正常前列腺患者的血流不同（分别为0.97 mL/[cm³×min⁻¹]和0.34 mL/[cm³×min⁻¹]；P < 0.001），前列腺癌患者与慢性前列腺炎患者的血流不同（分别为0.97 mL/[cm³×min⁻¹]和0.60 mL/[cm³×min⁻¹]；P = 0.026），慢性前列腺炎患者与正常前列腺患者的血流不同（分别为0.60 mL/[cm³×min⁻¹]和0.34 mL/[cm³×min⁻¹]；P = 0.023）。