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目的探讨磁共振成像(MRI)和磁共振波谱分析(MRS)对前列腺病变的诊断与鉴别诊断价值。方法回顾性分析30例前列腺病变,其中前列腺癌(Pca)11例,前列腺增生(BPH)19例,对其MRI和MRS影像学表现进行了研究。MRI平扫观察前列腺病变的位置、大小、形态及信号特点,MRS可观察枸橼酸盐(Cit)和胆碱复合物(Cho)、肌酸(Cre)的波峰及化学位移,并测定(Cho+Cre)．Cit值。结果11例PCa在T2 WI图像上表现为外周带的信号减低,其中7例为单侧局灶性,4例为双侧弥漫性; 19例BPH在T2 WI上均显示前列腺移行带和中央带的增大,其中13例表现为局灶性结节状高、低信号,6例表现为弥漫性体积增大,呈均匀低、等信号。MRS显示PCa的Cit峰明显下降,Cho峰升高,(Cho+Cre)．Cit值降低,而BPH病灶各代谢物波峰变化不明显,两者间(Cho+Cre)．Cit值有显著性差异(P＜0．05)。结论常规MRI与MRS的联合应用有利于提高PCa和BPH的诊断与鉴别诊断正确率。
Objective To investigate the value of magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) in the diagnosis and differential diagnosis of prostatic lesions. Methods A retrospective analysis of 30 cases of prostate lesions, including 11 cases of prostate cancer (Pca), 19 cases of benign prostatic hyperplasia (BPH), MRI and MRS imaging findings. MR imaging was used to observe the location, size, shape and signal characteristics of prostate lesions. The peak and chemical shift of citrate and cholinergic complex were measured by MRS. + Cre). Cit value. Results In 11 cases of PCa, the signal of peripheral zone was decreased in T2 WI, of which 7 cases were unilateral focal and 4 cases were bilateral diffuse. In 19 cases of BPH, the transitional zone of the prostate and central zone Of which 13 cases showed focal nodular high and low signal, 6 cases showed diffuse volume increase, showing a uniform low signal. MRS showed a significant decrease in the Cit peak of PCa and a rise in Cho peak (Cho + Cre). Cit value decreased, while BPH lesion metabolites peak was not obvious, the two (Cho + Cre). Cit values were significantly different (P <0.05). Conclusion The combination of routine MRI and MRS is helpful to improve the accuracy of diagnosis and differential diagnosis of PCa and BPH.