Molecular Imaging Program Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1088, USA.
BJU Int. 2012 Dec;110(11):1642-7. doi: 10.1111/j.1464-410X.2012.11469.x. Epub 2012 Sep 14.
Study Type--Diagnosis (case series) Level of Evidence 4. What's known on the subject? and What does the study add? Benign prostatic hyperplasia is the most common symptomatic disorder of the prostate and its severity varies greatly in the population. Various methods have been used to estimate prostate volumes in the past including the digital rectal examination and ultrasound measurements. High-resolution T2 weighted MRI can provide accurate measurements of zonal volumes and total volumes, which can be used to better understand the etiology of lower urinary tract symptoms of men.
• To use ability of magnetic resonance imaging (MRI) to investigate age-related changes in zonal prostate volumes.
• This Institutional Review Board approved, Health Insurance Portability and Accountability Act-compliant study consisted of 503 patients who underwent 3 T prostate MRI before any treatment for prostate cancer. • Whole prostate (WP) and central gland (CG) volumes were manually contoured on T2-weighted MRI using a semi-automated segmentation tool. WP, CG, peripheral zone (PZ) volumes were measured for each patient. • WP, CG, PZ volumes were correlated with age, serum prostate-specific antigen (PSA) level, International Prostate Symptom Score (IPSS), Sexual Health Inventory for Men (SHIM) scores.
• Linear regression analysis showed positive correlations between WP, CG volumes and patient age (P < 0.001); there was no correlation between age and PZ volume (P= 0.173). • There was a positive correlation between WP, CG volumes and serum PSA level (P < 0.001), as well as between PZ volume and serum PSA level (P= 0.002). • At logistic regression analysis, IPSS positively correlated with WP, CG volumes (P < 0.001). • SHIM positively correlated with WP (P= 0.015) and CG (P= 0.023) volumes. • As expected, the IPSS of patients with prostate volumes (WP, CG) in first decile for age were significantly lower than those in tenth decile.
• Prostate MRI is able to document age-related changes in prostate zonal volumes. • Changes in WP and CG volumes correlated inversely with changes in lower urinary tract symptoms. • These findings suggest a role for MRI in measuring accurate prostate zonal volumes; have interesting implications for study of age-related changes in the prostate.
本研究为诊断（病例系列）类研究，证据等级为 4 级。
良性前列腺增生是最常见的前列腺疾病，其严重程度在人群中差异很大。过去，人们使用了多种方法来估计前列腺体积，包括直肠指检和超声测量。高分辨率 T2 加权 MRI 可提供准确的前列腺分区体积和总体积测量，有助于更好地了解男性下尿路症状的病因。
利用磁共振成像（MRI）研究年龄相关性前列腺分区体积变化。
本研究经机构审查委员会批准，符合《健康保险流通与责任法案》的要求，共纳入 503 例在接受前列腺癌任何治疗前进行 3T 前列腺 MRI 检查的患者。在 T2 加权 MRI 上，使用半自动分割工具对整个前列腺（WP）和中央腺体（CG）体积进行手动勾画。为每位患者测量 WP、CG、外周带（PZ）体积。WP、CG、PZ 体积与年龄、血清前列腺特异性抗原（PSA）水平、国际前列腺症状评分（IPSS）、男性性功能健康问卷（SHIM）评分进行相关性分析。
线性回归分析显示 WP、CG 体积与患者年龄呈正相关（P<0.001）；年龄与 PZ 体积无相关性（P=0.173）。WP、CG 体积与血清 PSA 水平呈正相关（P<0.001），PZ 体积与血清 PSA 水平呈正相关（P=0.002）。Logistic 回归分析显示，IPSS 与 WP、CG 体积呈正相关（P<0.001）。SHIM 与 WP（P=0.015）和 CG（P=0.023）体积呈正相关。如预期的那样，WP、CG 体积在前 10%年龄组的患者的 IPSS 评分显著低于后 10%年龄组。
前列腺 MRI 能够记录与年龄相关的前列腺分区体积变化。WP 和 CG 体积的变化与下尿路症状的变化呈负相关。这些发现表明 MRI 在测量前列腺分区体积方面具有一定作用，对研究前列腺与年龄相关的变化具有重要意义。
