摘要
目的探讨基于第2版前列腺影像报告和数据系统(prostate imaging-reporting and data system version 2,PI-RADS V2)多参数磁共振成像(multiparametric magnetic resonance imaging,mp-MRI)对临床显著性移行带前列腺癌(transition zone prostate cancer,TZ-PCa)的诊断价值。材料与方法回顾性分析经病理证实的105例前列腺病变(前列腺癌41例,良性前列腺增生64例)的病例资料,所有患者行mp-MRI检查,包括T1WI、T2WI常规序列及扩散加权成像(diffusion weighted imaging,DWI)、动态增强MRI (dynamic constrast-enhanced MRI,DCE-MRI)功能成像。两位医师依据PI-RADS V2对T2WI、DWI、DCE-MRI各独立序列及mp-MRI (T2WI+DWI)联合技术评分,以病理结果为金标准绘制受试者工作特征(receiver operating characteristic,ROC)曲线,计算曲线下面积(area under curve,AUC),分析各方案对前列腺癌的诊断价值。结果两位医师PI-RADS评分具有较好的一致性(Kappa值=0.83)。T2WI、DWI、DCE-MRI及mp-MRI诊断移行带前列腺癌的AUC分别为0.914、0.887、0.773、0.927。经Medcalc分析,T2WI与mpMRI间AUC差异无统计学意义(P=0.107),余其他扫描方案间差异均有统计学意义(P<0.05),4种扫描方案诊断灵敏度、特异度分别为85.4%、84.4%,78.0%、81.3%,78.0%、76.6%,92.7%、83.9%。结论基于PI-RADS V2的mp-MRI对临床显著性移行带前列腺癌的诊断具有重要指导意义。
Objective:To investigate the diagnostic value of multiparametric MRI(mp-MRI)for detecting clinically significant transition zone prostate cancer(TZ-PCa)based on prostate imaging-reporting and data system version2(PI-RADS V2).Materials and Methods:Totally105patients undergoing prostate mp-MRI consisting of T2WI,diffusion weighted imaging(DWI)and dynamic contrast-enhanced MRI(DCE-MRI)were included and analyzed retrospectively.Among them41were confirmed TZ-PCa,64benign prostatic hyperplasia(BPH)by pathology within≤1week from MRI.T2WI,DWI,DCE-MRI and mp-MRI(T2WI+DWI)were scored based on PI-RADS V2by two diagnostic physicians,as well as calculating their sensitivity and specificity taking pathological results as gold standard.Receiver operating characteristic(ROC)curve was drawn and the area under curve(AUC)was performed to analyze the diagnostic efficiency of TZ-PCa with different protocols.Results:Inter-observer agreement of PI-RADS V2score was good(Kappa value=0.83).The AUC of T2WI,DWI,DCEMRI and mp-MRI for the diagnosis of TZ-PCa with PI-RADS V2were0.914,0.887,0.773,0.927,respectively.The AUC was not statistically significant difference between T2WI and mp-MRI(P=0.107),and statistically significant difference of AUC was found between the rest of each other scan protocols.The sensitivity and specificity were85.4%,84.4%for T2WI alone,78.0%,81.3%for DWI alone,78.0%,76.6%for DCE-MRI alone and92.7%,83.9%for mp-MRI.Conclusions:Multiparametic MRI based on PIRADS V2has important guiding significance in diagnosis of clinically significant transition zone prostate cancer.
作者
彭峰河
沈秀芝
蔡建新
李艳翠
孔广起
彭如臣
PENG Feng-he;SHEN Xiu-zhi;CAI Jian-xin;LI Yan-cui;KONG Guang-qi;PENG Ru-chen(Department of Radiology,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China;Department of Urology,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China)
出处
《磁共振成像》
CAS
CSCD
2018年第12期922-927,共6页
Chinese Journal of Magnetic Resonance Imaging
关键词
前列腺肿瘤
移行带
磁共振成像
前列腺影像报告和数据系统
Prostatic neoplasms
Transition zone
Magnetic resonance imaging
Prostate imaging-reporting and data system
