PI-RASD V2.0评分中双参数及多参数MRI诊断前列腺癌的对比研究

A Comparative Study of Bi-parametric MRI and Multi-parametric MRI in Diagnosis of Prostate Cancer Based on PI-RASD V2.0

目的对比多参数磁共振成像(multi-parametricMRI,MP-MRI)与双参数磁共振成像(biparametric-MRI,BPMRI)基于第2版前列腺影像报告和数据系统(prostateimaging-reportingand datasystemversion2,PI-RADSV2)评分在前列腺癌(PCa)诊断中应用价值。方法回顾性分析我院经病理证实PCa患者36例和BPH患者61例。均在穿刺前行MRI常规T1WI+T2WI、扩散加权成像(DWI)及动态增强(DCE)扫描。分别采用BPMRI(T2WI+DWI)与MP-MRI(T2WI+DWI+DCE)基于PI-RADSV2评分系统对病灶进行评分,并与病理结果对照,对比分析二者对PCa的诊断效能。结果 BP-MRI与MP-MRI基于PI-RADSV2评分均能很好地鉴别前列腺癌区与非癌(P<0.001)。BP-MRI与MP-MRI诊断PCa的敏感度、特异度、准确度、ROC曲线下面积分别为86.1%、83.6%、84.5%、0.927;91.7%、82%、85.6%、0.931。结论BP-MRI与MP-MRI基于PI-RADSV2评分均能很好发现PCa,对PCa的诊断具有重要价值。MP-MRI的敏感度和准确度稍高于BP-MRI,尤其是位于前列腺外周带的PCa,条件允许可优先选择。

Objective To compare the value of multi-parametric MRI(MP-MRI)and biparametric MRI(BP-MRI)based on the prostate imaging report and data system(PIRADS V2)version 2 in the diagnosis of prostate cancer(PCa).Methods 36 patients with PCa and 61 patients with BPH confirmed by pathology in our hospital were retrospectively analyzed.All patients underwent conventional T1WI+T2WI,diffusion weighted imaging(DWI)and dynamic contrast enhanced(DCE)sequences scans before puncture.The BP-MRI(T2WI+DWI)and MP-MRI(T2WI+DWI+DCE)were used to score the lesions based on the PI-RADS V2,and compared with the pathological results.The diagnostic efficacy of the two scanning schemes for PCa was analyzed and compared.Results Both BP-MRI and MP-MRI based on the PI-RADS V2 score can distinguish prostate cancer from non-cancer(P<0.001).The sensitivity,specificity,accuracy,and area under the ROC curve of BP-MRI and MP-MRI for diagnosis of PCa were 86.1%,83.6%,84.5%,0.927;91.7%,82%,85.6%,0.931,respectively.Conclusion Both BP-MRI and MP-MRI based on PI-RADS V2 can well detect PCa very well and have important value in the diagnosis of PCa.The sensitivity and accuracy of MP-MRI is slightly higher than that of BP-MRI,especially for PCa in the peripheral zone of the prostate,and conditions permit preferential selection.