前列腺癌的MRI诊断价值及其误诊原因分析

Analysis of misdiagnosis of MRI in the differential diagnosis of prostate cancer

目的:评价MRI对前列腺癌的定性诊断价值,分析前列腺癌MRI的误诊原因。方法:采用MRI技术对80例前列腺疾病患者进行检查,并经系统穿刺活检病理检查证实。结果:80例患者中,前列腺癌51例,前列腺良性病变29例。MRI对前列腺癌的定性诊断准确率为86.3%,敏感度90.2%,特异度79.3%,阳性预测值88.5%,阴性预测值82.1%。前列腺癌误诊6例,慢性前列腺炎(4例)、炎性肉芽肿(1例)、良性增生(1例)表现均与前列腺癌相似,鉴别困难。漏诊的5例前列腺癌中,1例信号强度和正常外周带信号相似,无法显示;2例受活检后出血信号干扰,无法显示肿瘤病灶;2例异常信号弥漫分布,误为慢性炎症。结论:MRI可用于前列腺癌的定性诊断,其特异性有待提高。

Objective:To investigate the usage of MRI in diagnosing the prostate cancer and analysis the reasons for MRI in the misdiagnosis.Methods:Eighty patients with systemic prostate biopsy pathologically proved diseases were examined with MRI. The utility of MR in the differential diagnosis was analyzed.Results:The final MRI diagnosis of the 80 prostates was as following: 51 prostate cancer, 29 benign prostate disease. The qualification accuracy of MRI was 86.3% (69/80) with sensitivity 90.2% and specificity79.3%. 4 chronic prostatitis, 1 acestoma and 1 benign hyperplasia were misdiagnosed as prostate cancer. One prostate cancer was undetected. Hemorrhage in PZ overlaid in two cases. Two cases misdiagnosis as chronic prostatitis. The reason of misdiagnosis was the lacking of specific features at MRI of prostate cancer.Conclusions:MRI is useful in diagnosing prostate cancer but its diagnotic specificity is not high. Clinical information may help improve the diagnosis accuracy.