The Diagnosis Value Of Magnetic Resonance Spectroscopy In Prostate Disease And The Comparaticve Study With Pathology

ObjectiveTo evaluate the value of 3.0T magnetic resonance spectroscopy in diagnosis prostate diseases and the possibility of MRS to evaluate the proliferation and angiogenesis of prostate cancer.Methods1,20 healthy volunteers and 53 cases prostate diseases person were scanned with conventional MR imaging,DEC-MR and MRS, The diagnisis of all 53 cases were proved by pathologic. Analyzing the (Cho + Cr) / Ci value. The three methods were made Kappa Concordance Test with pathologic, and using the ROC analysis software, getting the best diagnostic value of MRS for prostate cancer, and contrast with T2WI-fs and DEC-MRI. Analyzing the relationship of MRS with clinic staging and Gleason grade.2,22 prostate cancer and 22 BPH ,all from the above 53 cases, were made hematoxylin and eosin (HE) staining and immunohisto-chemical technique. To analyze the different expression of microvascular density (MVD)and vascular endothelial growth factor(VEGF) in prostate cancer and benign prostatic hyperplasia. To study the correlation of MRS with the cell proliferation and microvascular density and the expression of VEGF and Ki-67 in prostate cancer.Results1,The average ratios of (Cho + Cr) / Ci ranking from high to low were prostate cancer(2.47±1.71), BPH(0.52±0.37),nancancerous regions of PCa(0.47±0.33) and the normal peripheral zone(0.25±0.24), P= 0. 000.2,The kappa value of T2WI-fs,DEC-MR and MRS with pathologic was 0.313,0.538,0.657, when combined three methods, the Kappa value was 0.771. Using1.005 as the threshold, the sensitivity, specificity, positive predict value, negative predict value and accuracy for the diagnosis of PZPC were 89%,76%,81%,86%及83%, contrast with T2WI-fs(79%,56%,66%,70%,68%) and DCE-MRI(93%,60%, 72%,88%,77%), MRS had better diagnostic value, especially combined the three techniques, the sensitivity, specificity, positive predict value, negative predict value and accuracy for the diagnosis of PZPC cound get to 96%,80%,84%,95%及87%.3,Positive correlation was found between the (Cho + Cr) / Ci value and clinic staging(r=0.542,P=0.003)and gleason score(r=0.651,P=0.000).4,difference was found between prostate cancer and BPH in MVD (P=0.004)and VEGF(P=0.005). The study indicates that MVD,VEGF,Ki-67 and cellular density are closely related with the (Cho + Cr) / Ci value .Conclusion1,MRS with only external-body surface coil at 3.0T can be used to evaluate the metabolic level of prostate, especialty combined other MR techniques, it can obvious improve the diagnosis of prostate diseases.2,MRS can be used to evaluate the proliferation and angiogenesis of prostate cancer...