The Value Of The Combination Of MRI,MRS And PSA In The Diagnosis Of Prostate Carcinoma

Objective:To investigate the value of the combination of magnetic resonance imaging (MRI),magnetic resonance spectroscopy(MRS)and prostate specificantigen (PSA) in the diagnosis of prostate carcinoma(PCa).Materials and Methods:To chose 115 patients who were suffering from prostste disease and had the MRI in our hospital. After the examination of biopsy,operation pathology or following-up,66 units were confirmed as Pea and 49 units were confirmed as BPH. Among these patients,50 finishing the MRS scanning and all 115 patients obtained the PSA results. MRI observed the morphology,lesion location,signal characteristics and the range of tumor invasion range of the prostate. MRS observed the peak and the chemical shift of citrate(Cit), choline (Cho)and creatine(Cre), and calculated the ratio of(Cho+Cre)/Cit.Results:For the 115 units after the MRI examining on T2WI.66 units with PCa were low signal or the low bias signal, all PCa appeared as nodular or patchy hypointensity.37 units of PCa were localized in prostatic capsule, and 29 units of PCa were breakthrough the capsule. and 22 units were with the lymph node metastasis. Of 49 untis with BPH On T2WI,17 untis showed diffuse mixed signal, and 32 untis showed round or nodular hyperintensity(21 units)or hypointensity(11 units). On MRS,28 units of Pea in the peak fall cit and significant Cho peak higher,and the average ratio of Cho+Cre)/Cit is 2.17±1.17; 22 units of BPH in the significant Cho peak higher and the average ratio of (Cho+Cre)/Cit is 0.87±0.22. PCa the average ratio of Cho+Cre)/Cit in PCa was significantly higher than that of BPH (t=6.004, P<0.001). The Pca results range of the 115 cases are between 1.06-3236.7ng/ml, Which 66 units with Pca are between 3.33-3236.7ng /ml,including 58 units are>10 ng/ml and 8 units are<10 ng/ml;which 49 units BPH with PSA are in the range of 1.06～65.47 ng/ml, including 24 units are>10ng/ml and 25 units are<10ng/ml. The sensitivity, specificity and accuracy of MRI or MRS were less than 86% in the differentiation of PCa and BPH. The sensitivity, specificity and accuracy of MRI combinated with MRS increased to 92.8%,77.3%.86.0%, and the sensitivity, specificity and accuracy of MRI combinated with MRS and PSA increased to 96.4%,86.4%,92.0%, respectively.Conclusion:MRI can well reveal the location and signal features of BPH andPCa. MRS can provide the metabolic information of benign and malignant tissues. PSA can provide the increased the sensitivity. The combination application of MRI,MRS and PSA has significantly increased the diagnosis accuracy in the diferentiation of PCa and BPH.