高场强MRI在诊断及鉴别前列腺良恶性病变中的应用

Application of High Field MRI in the Diagnosis and Differentiation of Benign and Malignant Prostate Lesions

目的分析高场强磁共振成像(MRI)在诊断及鉴别前列腺良恶性病变中的应用价值。方法研究对象为本院自2015年1月~2018年12月收治的90例拟诊前列腺癌(Pca)患者,所纳入患者均有不同程度的排尿障碍、血尿症状,经手术或超声引导下前列腺穿刺活检病理诊断良性前列腺增生(BPH)57例,Pca33例;回顾性分析其场强MRI影像资料,并以手术或超声引导下前列腺穿刺活检病理诊断结果为参照,分析高场强MRI在诊断及鉴别前列腺良恶性病变中的应用价值。结果经高场强MRI诊断BPH47例,Pca43例,与病理诊断结果对照,高场强MRI诊断前列腺良恶性病变的灵敏度为70.18%、准确率为78.79%、特异度73.33%、阳性预测值85.10%、阴性预测值60.47%、Kappa值0.460。结论高场强磁MRI用于前列腺良恶性病变的诊断鉴别时具一定临床应用价值,值得临床重视。

Objective To analyze the application value of high field magnetic resonance imaging(MRI) in the diagnosis and differentiation of benign and malignant prostate lesions. Methods A total of 90 patients with possibleprostate cancer(Pca) who were admitted to the hospital from January 2015 to December 2018 were enrolled as study subjects. All included patients were with different degrees of urination disorders and hematuria, and 57 cases of benign prostatic hyperplasia(BPH) and 33 cases of Pca werediagnosed bysurgery or ultrasound-guided prostate biopsy pathology. The fieldMRI imaging data were retrospectively analyzed. The diagnostic results of surgery or ultrasound-guided prostate biopsy pathology were used as references to analyze the application value of high field MRI in the diagnosis and differentiation of benign and malignant prostate lesions. Results 47 cases of BPH and 43 cases of Pca were diagnosed by high field MRI. Compared with pathological diagnostic results, the sensitivity, accuracy rate, specificity, positive predictive value, negative predictive value and Kappa value of high field MRI in the diagnosis of benign and malignant prostate lesions were 70.18%, 78.79%, 73.33%, 85.10%, 60.47% and 0.460. Conclusion High field MRI has certain clinical application value in the diagnosis and differentiation of benign and malignant prostate lesions, which is worthy of clinical attention.