磁共振DWI联合PI-RADS评分对前列腺癌的筛查价值

Value of MRI DWI combined with PI-RADS in screening prostate cancer

目的探讨1.5T磁共振(MRI)表观扩散系数(ADC)值联合PI-RADS评分对前列腺癌(PCa)的筛查价值。方法选取2014年12月~2018年9月于蚌埠医学院第二附属医院病理科诊治的40例PCa患者作为PCa组,选取60例前列腺增生(BPH)患者作为良性组。两组均行1.5T-MRI检查。比较两组前列腺ADC值、指数化表观弥散系数(eADC)值及PI-RADS评分,比较不同方法诊断PCa的效能。结果 PCa组PI-RADS评分及eADC值均明显高于良性组,而ADC值明显低于良性组,差异均有高度统计学意义(P<0.01)。ROC曲线分析结果显示,ADC值联合PI-RADS评分诊断PCa的敏感度、特异度、Youden指数均高于ADC值和PI-RADS单独检测,且联合诊断曲线下面积最大。结论 1.5T-MRI的ADC值联合PI-RADS评分能够作为PCa筛检的主要标准,可以有效提升PCa的筛检功效,值得临床推广应用。

Objective To discuss the apparent diffusion coefficient(ADC) value of 1.5 T magnetic resonance(MRI combined with PI-RADS score in screening prostate cancer(PCa). Methods Forty patients with PCa were selected from December 2014 to September 2018 in the Second Affiliated Hospital of Bengbu Medical College, and as PCa group. At the same time, 60 patients with benign prostate were selected as benign group. The two groups were given 1.5 T-MRI examination. The prostate imaging ADC value, eADC value and PI-RADS score of the two groups were compared, the diagnosis performance of PCa with different methods were compared. Results The PI-RADS score and eADC value in PCa group were higher than those in the benign group, while ADC value was lower than that in the benign group, the differences were highly statistically significant(P<0.01). The ROC curve analysis showed that, the sensitivity, specificity and Youden index of ADC value combined with PI-RADS score in the diagnosis of PCa were significantly higher than the ADC and PI-RADS score alone, and the area under the curve of combined diagnosis was the biggest. Conclusion The ADC value of 1.5 T-MRI combined with PI-RADS score can be used as a primary indicator of PCa screening. And it can effectively improve the screening effect of PCa, it is worth for clinical promotion and application.