磁共振灌注（MRP）和弥散加权成像（DWI）在前列腺癌中的应用：基于定量和模型的钆喷酸葡胺 MRP 参数在前列腺癌检测中的应用。

MR-perfusion (MRP) and diffusion-weighted imaging (DWI) in prostate cancer: quantitative and model-based gadobenate dimeglumine MRP parameters in detection of prostate cancer.

机构信息

Institute of Clinical Radiology, University of Munich, Munich, Germany.

出版信息

Eur J Radiol. 2010 Dec;76(3):359-66. doi: 10.1016/j.ejrad.2010.04.023. Epub 2010 May 14.

DOI:10.1016/j.ejrad.2010.04.023

PMID:20471189

Abstract

BACKGROUND

Various MR methods, including MR-spectroscopy (MRS), dynamic, contrast-enhanced MRI (DCE-MRI), and diffusion-weighted imaging (DWI) have been applied to improve test quality of standard MRI of the prostate.

PURPOSE

To determine if quantitative, model-based MR-perfusion (MRP) with gadobenate dimeglumine (Gd-BOPTA) discriminates between prostate cancer, benign tissue, and transitional zone (TZ) tissue.

MATERIAL AND METHODS

27 patients (age, 65±4 years; PSA 11.0±6.1 ng/ml) with clinical suspicion of prostate cancer underwent standard MRI, 3D MR-spectroscopy (MRS), and MRP with Gd-BOPTA. Based on results of combined MRI/MRS and subsequent guided prostate biopsy alone (17/27), biopsy and radical prostatectomy (9/27), or sufficient negative follow-up (7/27), maps of model-free, deconvolution-based mean transit time (dMTT) were generated for 29 benign regions (bROIs), 14 cancer regions (cROIs), and 18 regions of transitional zone (tzROIs). Applying a 2-compartment exchange model, quantitative perfusion analysis was performed including as parameters: plasma flow (PF), plasma volume (PV), plasma mean transit time (PMTT), extraction flow (EFL), extraction fraction (EFR), interstitial volume (IV) and interstitial mean transit time (IMTT). Two-sided T-tests (significance level p<0.05) discriminated bROIs vs. cROIs and cROIs vs. tzROIs, respectively.

RESULTS

PMTT discriminated best between bROIs (11.8±3.0 s) and cROIs (24.3±9.6 s) (p<0.0001), while PF, PV, PS, EFR, IV, IMTT also differed significantly (p 0.00002-0.0136). Discrimination between cROIs and tzROIs was insignificant for all parameters except PV (14.3±2.5 ml vs. 17.6±2.6 ml, p<0.05).

CONCLUSIONS

Besides MRI, MRS and DWI quantitative, 2-compartment MRP with Gd-BOPTA discriminates between prostate cancer and benign tissue with several parameters. However, distinction of prostate cancer and TZ does not appear to be reliable.

摘要

背景

各种磁共振方法，包括磁共振波谱（MRS）、动态对比增强磁共振成像（DCE-MRI）和弥散加权成像（DWI），已被应用于提高前列腺标准磁共振成像的检测质量。

目的

确定使用钆喷酸葡胺（Gd-BOPTA）进行基于模型的定量磁共振灌注（MRP）是否可以区分前列腺癌、良性组织和移行区（TZ）组织。

材料与方法

27 例临床疑似前列腺癌患者（年龄 65±4 岁；PSA 11.0±6.1ng/ml）进行了标准 MRI、3D 磁共振波谱（MRS）和 Gd-BOPTA 磁共振灌注成像。根据联合 MRI/MRS 检查结果，以及随后的单独前列腺活检（27 例中的 17 例）、前列腺切除术（27 例中的 9 例）或充分的阴性随访（27 例中的 7 例），为 29 个良性区域（bROI）、14 个癌症区域（cROI）和 18 个移行区（tzROI）生成了模型自由、解卷积平均渡越时间（dMTT）图。应用双室交换模型，进行定量灌注分析，包括以下参数：血流（PF）、血浆容积（PV）、血浆平均通过时间（PMTT）、提取流（EFL）、提取分数（EFR）、间质容积（IV）和间质平均通过时间（IMTT）。双侧 t 检验（显著性水平 p<0.05）分别区分 bROI 与 cROI 和 cROI 与 tzROI。

结果

PMTT 可最佳地区分 bROI（11.8±3.0s）与 cROI（24.3±9.6s）（p<0.0001），而 PF、PV、PS、EFR、IV、IMTT 也有显著差异（p<0.00002-0.0136）。除 PV 外（14.3±2.5ml 与 17.6±2.6ml，p<0.05），cROI 与 tzROI 之间的所有参数均无显著差异。