The Value Of PWI-quantitative Parameters And 3D ~1H-MRS In The Diagnosis Of Prostate Cancer

Objective: To investigate the value of dynamic contrast enhanced(DCE)perfusion parameters and magnetic resonance spectroscopy(MRS)in the diagnosis of prostate(PCa),and the correlation between the ratio of prostate specific antigen(PSA)and the parameters of DCE perfusion and MRS.Methods: Twenty-five patients with non-PCa confirmed by pathology or diagnostic treatment(17 patients with benign prostatic hyperplasia,8 patients with benign prostatic hyperplasia and inflammation),16 patients with pathologically or follow-up confirmed PCa,and normal healthy volunteers 20 cases,were subjected prostate magnetic resonance imaging(MRI),DCE,MRS examination.Total prostate specific antigen(T-PSA),free prostate specific antigen(F-PSA)were detected in all patients and healthy volunteers before scanning.Results: 1.The total prostate specific antigen(T-PSA)values of the PCa group,the non-PCa group and the normal control group were respectively(52.60�103.26ng/m L),(15.09�9.75ng/m L),(2.46�0.68ng/m L).The free prostate specific antigen(F-PSA)values of the three groups were respectively(4.56 �3.48ng/m L),(2.08 �1.15ng/m L),(0.59 �0.16ng/m L).The F/T-PSA values of the three groups were respectively(0.18�0.08),(0.15�0.05),(0.24�0.04).2.The transfer rate constant(K~trans)values of the three groups were respectively(0.19�0.07min-1),(0.11�0.03min-1),(0.06�0.02min-1),between all of the groups were statistically significant(P<0.05).3.The rate constant(Kep)values of the three groups were respectively(1.06�0.13min-1),(0.73�0.19min-1),(0.63�0.11min-1),between all of the groups were statistically significant(P<0.05).4.The extravascular extracellular space volume fraction(Ve)values of the three groups were respectively(0.17�0.07),(0.11�0.04)and(0.10�0.03),there was significant difference between the groups(P<0.05),and there was significant difference between the PCa group and the control group(P<0.05),but there was no significant difference between the non-PCa group and the normal control group(P>0.05).5.The best optimal thresholds of K~trans,Kep and Ve in diagnosing PCa were respectively 0.14min-1,0.925min-1,0.145.6.(Cho+Cr)/Cit values in the PCa group,the non-PCa group and the normal control group were respectively(5.17�3.68),(0.70�0.43)and(0.37�0.47),and the difference between all of the groups were statistically significant(P<0.05).7.The correlation coefficient �r� between F/T-PSA and K~trans,Kep,Ve,(Cho+Cr)/Cit values in the PCa gruop and the non-PCa gruop were respectively0.038(P>0.05),0.05(P>0.05),-0.013(P>0.05),and 0.338(P<0.05).Conclusion: 1.Both DCE and MRS have important value in diagnosis and differential diagnosis of PCa.2.In the DCE perfusion parameters(K~trans,Kep,Ve),K~trans and Kep have the highest diagnostic performance,the specificity of K~trans is higher,and Kep has higher sensitivity.3.There was a weak correlation between F/T-PSA and(Cho+Cr)/Cit,and there was no significant correlation with DCE perfusion parameters.