The Value Of DWI And 3D ~1H-MRS For The Differential Diagnosis Of Beign And Malignant Disease Of The Prostate

Objective:To research the value of diffusion weighted imaging (DWI),three dimensional magnetic resonance spectroscopy (3D 1H-MRS) for the diagnosis and differential diagnosis of differentiate benign and malignant lesion of the prostate after all patients scaned of MRI,DWI,3D 1H-MRS.Methods:33 cases of prostatitis patients, mean age 31±2.5 years (from 19 to 45) proved by pathology or Laboratory test.26 cases of prostate cancers, mean age 67±1.7 years (from 54 to 83) proved by pathology,30 cases of benign prostate hyperplasia, mean age 68±3.2 years (from 51 to 85) and divided into glandular benign prostate hyperplasia (gBPH),stromal Benign prostate hyperplasia (sBPH) according to histopathology after operation, and 20 cases of normal volunteers, mean age 24±6.3 years (from 19 to 40) were presented. Abnormal magnetic resonance imaging (MRI),diffusion weighted imaging (DWI b-values=0s/mm2 600s/mm2 and 800s/mm2) and three diamential magnetic rensonance spectroscopy (3D 1H-MRS) images were obtained for all cases on Philips Intera 1.5T Achieva Nova-Dual system. All patients and volunteer would be checked the Prostate specific antigen (PSA).Results:The mean Apparent diffusion coefficient (ADC) (b=600s/mm2) values of prostatitis lesion,prostate cancer,glandular benign prostate hyperplasia(gBPH),stromal Benign prostate hyperplasia (sBPH) and normal volunteer were (1.60±0.17)×10-3 mm2/s,(0.83±0.13)×10-3 mm2/s,(1.91±0.15)×10-3 mm2/s,(1.37±0.14)×10-3 mm2/s,(2.14±0.13)×10-3 mm2/s, respectively significant difference (one-way ANOV, P<0.05) was found. Furthermore, statistical significant difference also existed between every two groups (LSD) (P< 0.05) except plastatitis lesion and glandular BPH (P> 0.05). The mean ADC (b=800s/mm2) value were (1.52±0.14)×10-3 mm2/s,(0.81±0.17)×10-3 mm2/s,(1.63±0.12)×10-3 mm2/s,(1.35±0.11)×10-3 mm2/s,(1.98±0.15)×10-3 mm2/s, respectively significant difference (one-way ANOV, P< 0.05) was found. Furthermore, statistical significant difference also existed between every two groups (LSD) (P< 0.05) except plastatitis lesion and glandular BPH (P> 0.05) too.But the ADC value has 30% overlap between stromal Benign prostate hyperplasia and prostate cancer. The mean (cho+cre)/cit values of the prostatitis lesion,prostate cancer,glandula BPH,stroma BPH and normal peripheral zone were(0.55±0.21),(2.01±1.96),(0.41±0.15) (0.65±0.23) (0.43±0.14), respectively Statistical significant difference was found (one-way ANOV, P< 0.05), There are statistical significant difference in every groups compared with Prostate cancer group. The ADC (b=600s/mm2) value forⅠ-Ⅳtype of prostatitis are (1.55±0.12)×10-3 mm2/s,(1.58±0.17)×10-3 mm2/s,(1.50±0.23)×10-3 mm2/s,(1.62±0.18)×10-3 mm2/s, Statistical significant difference was not found (one-way ANOV, P>0.05). The ADC (b=800s/mm2) value forⅠ-Ⅳtype of prostatitis were (1.47±0.13)×10-3 mm2/s,(1.55±0.18)×10-3 mm2/s,(1.49±0.24)×10-3 mm2/s,(1.58±0.21)×10-3 mm2/s, Statistical significant difference was not found (one-way ANOV P> 0.05) too. The value of (Cho+Cre)/Cit forⅠ-Ⅳtype of prostatitis were (0.53±0.11),(0.58±0.13),(0.50±0.24),(0.49±0.17), Statistical significant difference was not found (one-way ANOV, P> 0.05) too.Conclusion:1. The ADC value has important value on the diagnosis and differential diagnosis of benign and malignant disease of the prostate, but the ADC value has thirty percent overlap between stromal benign prostate hyperplasia and prostate cancer.2. The 3D 1H-MRS have important value on the diagnosis and differential diagnosis of benign and malignant disease of the prostate,but the (Cho+Cre)/Cit value in the 3D 1H-MRS maps have no Statistical significant difference between benign prostate diseases.3. The study proved that combined with normal MRI, DWI and 3D'H-MRS has important value for diagnosis and differential diagnosis of benign and malignant disease of the prostate.