多参数MRI对前列腺癌精囊侵犯的诊断价值

Evaluation of multiparametric MRI in predicting seminal vesicle invasion of prostate cancer

目的探讨多参数MRI(mpMRI)对前列腺癌精囊侵犯(SVI)的诊断价值。方法 52例前列腺癌患者行术前mpMRI检查,由一名影像科医师综合T_2WI、扩散加权成像(DWI)和动态对比增强(DCE)影像表现,评价左、右侧精囊是否受累,并与前列腺根治术后病理结果进行对比。结果病理证实104侧精囊中有15侧精囊受累,读片者准确识别11侧,漏诊4侧,误诊1侧。mpMRI诊断准确率、敏感度、特异度、阴性预测值和阳性预测值分别为95.2%、73.3%、98.9%、95.7%和91.7%,与病理结果一致性良好(K_(appa)值=0.794)。结论 mpMRI对前列腺癌精囊侵犯具有较高的临床价值。

Objective To evaluate the value of multiparametric MRI（mp MRI） in predicting seminal vesicle invasion（SVI） of prostate cancer. Methods Preoperative mpMRI including T2-weighted imaging（T2WI）, diffusion-weighted imaging（DWI） and dynamic contrast enhancement（DCE） of 52 patients with prostate cancer was interpreted by one experienced radiologist. The seminal vesicles were evaluated and compared with pathology from radical prostatectomy. Results SVI was found in 15 of 104 sides on pathology. 11 foci were correctly identified, 4 were missed and 1 was misdiagnosed by the radiologist on mp MRI. The diagnostic accuracy, sensitivity, specificity, negative and positive predictive values of mpMRI were 95.2%, 73.3%, 98.9%, 95.7% and 91.7%, respectively. The concordance with pathology was good（κ=0.794）. Conclusion MpMRI is valuable in predicting SVI of prostate cancer.