双参数磁共振成像在前列腺癌检出方面的应用——基于前列腺癌根治术病理大切片为对照的研究

Application of biparametric magnetic resonance imaging in the detection of prostate cancer:a contrastive study based on whole mount section after radical prostatectomy

目的探索双参数磁共振成像(biparametric magnetic resonance imaging,bpMRI)在前列腺癌(prostate cancer,PCa)检出方面的应用。材料与方法收集我院2017年5月至2019年9月期间临床怀疑前列腺癌,行术前常规bpMRI检查,之后行前列腺癌根治术并行病理大切片的患者进行回顾性分析,将包括T2WI、扩散加权成像(diffusion weighted imaging,DWI)及ADC在内的双参数MR图像与病理大切片图像进行匹配分析,探索bpMRI在前列腺癌灶检出方面的敏感性,并分析影响前列腺癌灶检出的因素。结果67例患者,病理大切片确认病灶123个,术前bpMRI检出病灶94个,直径>1 cm的癌灶检出率为92.1%,Gleason评分大于3+3的前列腺癌检出率为84.3%。癌灶大小(P<0.001)和Gleason评分(P=0.008)分别为癌灶检出的独立预测因子,移行带癌灶检出率与外周带癌灶检出率无统计学差异。结论bpMRI对前列腺癌灶的检出有较高的敏感性,尤其是对直径大于1 cm或Gleason评分>6分的病灶敏感性高。

Objective:To explore the application of biparametric magnetic resonance imaging(bpMRI)in the detection of prostate cancer(PCa)based on whole-mount histopathology.Materials and Methods:From May 2017 to September 2019,a retrospective analysis was used to identify the predictive factors affecting the detection of prostate cancer,based on a database correlating lesion-specific results from bpMRI co-registered with whole-mount pathology(WMP)prostatectomy specimens.Results:In 67 patients,123 lesions were confirmed by whole-mount pathology.Tumor detection increases with tumor size and Gleason score.The detection rate of 1.0 cm foci was 92.1%,and that of Gleason score greater than 3+3 was 84.3%.Cancer focal size(P<0.001)and Gleason score(P=0.008)were independent predictors of tumor detection,respectively.There was no statistical difference in the detection rate between the transitional zone and peripheral zone.Conclusions:bp MRI is highly sensitive to the detection of prostate cancer,especially for foci larger than 1 cm in diameter or Gleason score>6.